Healthcare Provider Details

I. General information

NPI: 1447248083
Provider Name (Legal Business Name): MICHAEL DAVID SAXE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8710 W CHARLESTON BLVD SUITE 100
LAS VEGAS NV
89117-5469
US

IV. Provider business mailing address

8710 W CHARLESTON BLVD SUITE 100
LAS VEGAS NV
89117-5469
US

V. Phone/Fax

Practice location:
  • Phone: 702-255-0133
  • Fax: 702-255-8374
Mailing address:
  • Phone: 702-255-0133
  • Fax: 702-255-8374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberS6-16
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: