MEDICARE: DR. PAUL SABLAN SAUGET D.D.S., M.S.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0109	MP
2	1223G0001X	General Practice Dentistry	22067	TX
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	62374	CA
4	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-243C	NV
5	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	D-1017	GU

General Provider Information

NPI Number	:	1538152178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SABLAN SAUGET D.D.S., M.S.D.

Provider Business Mailing Address
First Line	:	643 CHALAN SAN ANTONIO STE 104
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3644
Country	:	US
Telephone Number	:	671-648-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	643 CHALAN SAN ANTONIO STE 104
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3644
Country	:	US
Telephone Number	:	671-648-9888
Fax Number	:	671-648-9894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	02/25/2020

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