Provider Demographics
NPI:1073034088
Name:SAGE DENTISTRY V PLLC
Entity Type:Organization
Organization Name:SAGE DENTISTRY V PLLC
Other - Org Name:FAMILY AND IMPLANT DENTISTRY OF BELMAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLACK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-989-4444
Mailing Address - Street 1:325 S TELLER ST STE 208
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-7388
Mailing Address - Country:US
Mailing Address - Phone:303-989-4444
Mailing Address - Fax:
Practice Address - Street 1:325 S TELLER ST STE 208
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7388
Practice Address - Country:US
Practice Address - Phone:303-989-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202525261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental