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General NPI Number Information
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NPI Number | 1285148395
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Entity Type | Organization
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Legal Business Name | MARY J. SAYEGH, DMD, LLC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 182 FAIRFIELD RD
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2421
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Country | US
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Telephone | 973-941-6962
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Fax |
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Provider Business Mailing Address
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Address Line | 4 DE YOUNG DR
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-2361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY J SAYEGH
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Credential | DMD
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Telephone | 973-941-6962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 059195-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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