Healthcare Provider Details

I. General information

NPI: 1134124712
Provider Name (Legal Business Name): CHRISTOPHER JOHN SAAL DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 POLK ST
HOUMA LA
70360-6011
US

IV. Provider business mailing address

1608 POLK ST
HOUMA LA
70360-6011
US

V. Phone/Fax

Practice location:
  • Phone: 985-879-1972
  • Fax: 985-879-4661
Mailing address:
  • Phone: 985-879-1972
  • Fax: 985-879-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number021634
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: