Healthcare Provider Details

I. General information

NPI: 1891428629
Provider Name (Legal Business Name): RAMAN SAHA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 BROADWAY BLVD
GARLAND TX
75043-3435
US

IV. Provider business mailing address

PO BOX 258841 DEPT 2
OKLAHOMA CITY OK
73125
US

V. Phone/Fax

Practice location:
  • Phone: 972-240-0400
  • Fax: 972-240-0676
Mailing address:
  • Phone: 877-667-7669
  • Fax: 888-920-7457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number38491
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: