Provider Demographics
NPI:1013369487
Name:SAGGESE, NICHOLAS PAUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:PAUL
Last Name:SAGGESE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 GOOSE LN STE 204
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2186
Mailing Address - Country:US
Mailing Address - Phone:203-453-7700
Mailing Address - Fax:203-458-5085
Practice Address - Street 1:246 GOOSE LN STE 204
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2186
Practice Address - Country:US
Practice Address - Phone:203-453-7700
Practice Address - Fax:203-458-5085
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT126511223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program