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General NPI Number Information
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NPI Number | 1255473559
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Entity Type | Organization
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Legal Business Name | ROBERT A. SADLER DDS, PA
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1016 MISSION 66
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City | VICKSBURG
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State | MS
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Zip | 39183-2752
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Country | US
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Telephone | 601-638-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 MISSION 66
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City | VICKSBURG
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State | MS
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Zip | 39183-2752
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Country | US
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Telephone | 601-638-3661
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT A SADLER
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Credential | DDS
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Telephone | 601-638-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1809-78
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License Number State | MS
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