Healthcare Provider Details

I. General information

NPI: 1093903676
Provider Name (Legal Business Name): ROGER ANTONIO SAENZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 06/17/2023
Certification Date: 06/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 W 29TH ST
HIALEAH FL
33012-5606
US

IV. Provider business mailing address

9743 NW 30TH ST
DORAL FL
33172-1081
US

V. Phone/Fax

Practice location:
  • Phone: 305-885-9786
  • Fax: 305-885-7682
Mailing address:
  • Phone: 305-898-9228
  • Fax: 305-885-7682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN14217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: