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NPI 1134207186

NPI 1134207186 : SCOTT D. SAZIMA DDS : WESTLAKE, OH

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General NPI Number Information
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    NPI Number           |    1134207186
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT D. SAZIMA DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/01/2006
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    Last Update Date     |    02/26/2008
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Provider Practice Location Address
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    Address Line         |    26032 DETROIT RD STE 8
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    City                 |    WESTLAKE
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    State                |    OH
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    Zip                  |    44145-2478
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    Country              |    US
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    Telephone            |    440-835-4600
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    Fax                  |    440-835-4652
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Provider Business Mailing Address
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    Address Line         |    26032 DETROIT RD STE 8
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    City                 |    WESTLAKE
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    State                |    OH
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    Zip                  |    44145-2478
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    Country              |    US
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    Telephone            |    440-835-4600
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    Fax                  |    440-835-4652
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223P0300X
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    Taxonomy Name        |    Periodontics
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    License Number       |    17967
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    License Number State |    OH
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