Basic Information
| Provider Information | |||||||||
| NPI: | 1033299987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALE | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3045 S NATIONAL AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658044268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178886790 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3045 S NATIONAL AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658044268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178886790 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0528427 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2017038663 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.