Provider Demographics
NPI:1407664774
Name:EMBRACE ARLINGTON
Entity type:Organization
Organization Name:EMBRACE ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PROUTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-884-9341
Mailing Address - Street 1:122 S. MAIN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:SD
Mailing Address - Zip Code:57212
Mailing Address - Country:US
Mailing Address - Phone:605-983-5756
Mailing Address - Fax:605-256-4717
Practice Address - Street 1:122 S. MAIN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:SD
Practice Address - Zip Code:57212
Practice Address - Country:US
Practice Address - Phone:605-983-5756
Practice Address - Fax:605-256-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental