Provider Demographics
NPI:1275208530
Name:SAILER, LUKE MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:MATTHEW
Last Name:SAILER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 JUNIPER AVE
Mailing Address - Street 2:
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1041
Mailing Address - Country:US
Mailing Address - Phone:218-631-2515
Mailing Address - Fax:218-632-2517
Practice Address - Street 1:145 JUNIPER AVE
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-1041
Practice Address - Country:US
Practice Address - Phone:218-631-2515
Practice Address - Fax:218-632-2517
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist