Healthcare Provider Details

I. General information

NPI: 1992908156
Provider Name (Legal Business Name): MARK SAYED D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32341 CAMINO CAPISTRANO STE H
SAN JUAN CAPISTRANO CA
92675-4514
US

IV. Provider business mailing address

32341 CAMINO CAPISTRANO STE H
SAN JUAN CAPISTRANO CA
92675-4514
US

V. Phone/Fax

Practice location:
  • Phone: 949-493-3993
  • Fax: 949-493-9562
Mailing address:
  • Phone: 949-493-3993
  • Fax: 949-493-9562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number37910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: