MEDICARE: DR. SAEID BADIE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D4687	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	359415	OTHER	AZ	AHCCCS

General Provider Information

NPI Number	:	1154426203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAEID BADIE D.D.S.

Provider Business Mailing Address
First Line	:	718 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4506
Country	:	US
Telephone Number	:	520-325-3022
Fax Number	:	520-325-3181

Provider Business Practice Location Address
First Line	:	718 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4506
Country	:	US
Telephone Number	:	520-325-3022
Fax Number	:	520-325-3181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/08/2007

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