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General NPI Number Information
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NPI Number | 1609982461
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Entity Type | Organization
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Legal Business Name | MARVIN & RICHARD SAGERMAN DDS
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25061 N PEACHLAND AVE
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City | NEWHALL
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State | CA
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Zip | 91321
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Country | US
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Telephone | 661-255-7530
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Fax | 661-254-4798
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Provider Business Mailing Address
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Address Line | 25061 N PEACHLAND AVE
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City | NEWHALL
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State | CA
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Zip | 91321
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Country | US
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Telephone | 661-255-7530
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Fax | 661-254-4798
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARVIN A SAGERMAN
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Credential | DDS
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Telephone | 661-255-7530
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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 | 19157
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19156
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License Number State | CA
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