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General NPI Number Information
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NPI Number | 1730456948
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Entity Type | Individual
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Provider Name | NICHOLAS BRANDON SAGER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 506 N HEWITT DR
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City | HEWITT
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State | TX
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Zip | 76643-3038
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Country | US
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Telephone | 254-666-1686
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Fax | 254-666-9252
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Provider Business Mailing Address
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Address Line | 208 STONE FOREST DR
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City | WOODWAY
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State | TX
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Zip | 76712-3039
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Country | US
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Telephone | 254-855-3899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 27072
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License Number State | TX
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