Healthcare Provider Details

I. General information

NPI: 1104948579
Provider Name (Legal Business Name): NORMAN DEAN SAAGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 E BROADWAY AVE
MILTON FREEWATER OR
97862-1315
US

IV. Provider business mailing address

34 NE TREMONT DR
COLLEGE PLACE WA
99324-1149
US

V. Phone/Fax

Practice location:
  • Phone: 541-938-3363
  • Fax:
Mailing address:
  • Phone: 509-520-2183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number4973
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: