Healthcare Provider Details

I. General information

NPI: 1285887034
Provider Name (Legal Business Name): WILLIAM A SAUPE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 ASHBY AVE
BERKELEY CA
94705-2002
US

IV. Provider business mailing address

2416 ASHBY AVENUE
BERKELEY CA
94705-2002
US

V. Phone/Fax

Practice location:
  • Phone: 510-548-0317
  • Fax: 510-548-7013
Mailing address:
  • Phone: 510-548-0317
  • Fax: 510-548-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number38460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: