Healthcare Provider Details

I. General information

NPI: 1295868776
Provider Name (Legal Business Name): GEORGE J R SAUER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 S MAIN ST
SHARON MA
02067-1818
US

IV. Provider business mailing address

45 FULLER ST
DEDHAM MA
02026-4123
US

V. Phone/Fax

Practice location:
  • Phone: 781-784-7391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number12840
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: