Provider Demographics
NPI:1528399730
Name:SATHER FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:SATHER FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-925-4545
Mailing Address - Street 1:118 DOUGLAS ST
Mailing Address - Street 2:P.O. BOX 777
Mailing Address - City:CHETEK
Mailing Address - State:WI
Mailing Address - Zip Code:54728-9508
Mailing Address - Country:US
Mailing Address - Phone:715-925-4545
Mailing Address - Fax:715-925-4546
Practice Address - Street 1:118 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:CHETEK
Practice Address - State:WI
Practice Address - Zip Code:54728-9508
Practice Address - Country:US
Practice Address - Phone:715-925-4545
Practice Address - Fax:715-925-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5581-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty