MEDICARE: SAGAR DENTAL

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1720513229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGAR DENTAL

Provider Business Mailing Address
First Line	:	17503 LA CANTERA PKWY
Second Line	:	#104-606
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-8207
Country	:	US
Telephone Number	:	210-627-6305
Fax Number	:	210-681-8887

Provider Business Practice Location Address
First Line	:	17803 LA CANTERA TER
Second Line	:	#8122
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2545
Country	:	US
Telephone Number	:	210-627-6305
Fax Number	:	210-681-8887

Authorized Official
Title or Position	:	OWNER
Name	:	AALIE SAGAR
Credential	:
Telephone Number	:	210-627-6305

Provider Enumeration Date	:	04/22/2017
Last Update Date	:	04/29/2017

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Directions to “SAGAR DENTAL ” Practice Location

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