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General NPI Number Information
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NPI Number | 1285151290
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Entity Type | Organization
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Legal Business Name | SAGE DENTISTRY VI
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 8725 WADSWORTH BLVD STE B
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City | ARVADA
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State | CO
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Zip | 80003-0922
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Country | US
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Telephone | 303-420-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 8725 WADSWORTH BLVD STE B
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City | ARVADA
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State | CO
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Zip | 80003-0922
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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 | DR. SAGE E POLLACK
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Credential | D.M.D.
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Telephone | 720-231-2755
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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 | DEN.00202525
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License Number State | CO
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