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NPI 1104329465

NPI 1104329465 : SAAD SAGMAN, DDS, INC : REDLANDS, CA

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General NPI Number Information
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    NPI Number           |    1104329465
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    Entity Type          |    Organization 
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    Legal Business Name  |    SAAD SAGMAN, DDS, INC 
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Dates
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    Enumeration Date     |    03/13/2018
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    Last Update Date     |    05/02/2018
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Provider Practice Location Address
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    Address Line         |    1568 ORANGE ST 
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    City                 |    REDLANDS
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    State                |    CA
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    Zip                  |    92374-2274
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    Country              |    US
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    Telephone            |    909-800-3344
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1669 HARRISON LN 
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    City                 |    REDLANDS
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    State                |    CA
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    Zip                  |    92374-4721
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    Country              |    US
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    Telephone            |    909-800-3344
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     SAAD F SAGMAN 
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    Credential           |    DDS
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    Telephone            |    909-800-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    61322
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    License Number State |    CA
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