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General NPI Number Information
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NPI Number | 1780835975
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Entity Type | Organization
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Legal Business Name | ADVANCED SMILE DESIGN, INC.
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 528 N 1ST AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-1402
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Country | US
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Telephone | 906-265-0050
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Fax | 906-265-0069
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Provider Business Mailing Address
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Address Line | 528 N 1ST AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-1402
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Country | US
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Telephone | 906-265-0050
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Fax | 906-265-0069
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FREDERICK M SAIGH III
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Credential | DDS
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Telephone | 906-265-0050
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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 | 2901010729
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License Number State | MI
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