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General NPI Number Information
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NPI Number | 1083618664
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Entity Type | Organization
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Legal Business Name | IVI Z SANGUINETTI DDS PA
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 6920 GARTH RD
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City | BAYTOWN
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State | TX
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Zip | 77521-9646
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Country | US
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Telephone | 281-421-5950
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Fax | 281-421-7828
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Provider Business Mailing Address
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Address Line | 6920 GARTH RD
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City | BAYTOWN
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State | TX
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Zip | 77521-9646
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Country | US
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Telephone | 281-421-5950
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Fax | 281-421-7828
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Authorized Official
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Title or Position | DENTIST / OWNER / PRESIDENT
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Name | DR. IVI Z SANGUINETTI
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Credential | DDS, PA
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Telephone | 281-421-5950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17943
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License Number State | TX
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