Provider Demographics
NPI:1114329265
Name:JOSH BROWER DDS PROF LLC
Entity Type:Organization
Organization Name:JOSH BROWER DDS PROF LLC
Other - Org Name:WWW-SMILESFORSIOUXLAND-COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:800-516-7631
Mailing Address - Street 1:3405 S CATHY AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2702
Mailing Address - Country:US
Mailing Address - Phone:800-516-7631
Mailing Address - Fax:
Practice Address - Street 1:5000 W EMPIRE MALL
Practice Address - Street 2:EMPIRE MALL SUITE 924
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-6523
Practice Address - Country:US
Practice Address - Phone:800-516-7631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM872261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental