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General NPI Number Information
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NPI Number | 1326286709
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Entity Type | Organization
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Legal Business Name | J SAM SAGE DDS PS
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 9730 3RD AVE NE STE 209
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City | SEATTLE
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State | WA
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Zip | 98115-2023
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Country | US
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Telephone | 206-362-6677
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Fax | 206-362-2586
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Provider Business Mailing Address
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Address Line | 9730 3RD AVE NE STE 209
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City | SEATTLE
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State | WA
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Zip | 98115-2023
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Country | US
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Telephone | 206-362-6677
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Fax | 206-362-2586
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Authorized Official
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Title or Position | OWNER
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Name | JOHN SAMUEL SAGE
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Credential | DDS
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Telephone | 206-362-6677
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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 |
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License Number State |
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