Provider Demographics
NPI:1073504270
Name:SACHS, MARTIN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:P
Last Name:SACHS
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 1:5 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4305
Mailing Address - Country:US
Mailing Address - Phone:203-762-5141
Mailing Address - Fax:203-762-9011
Practice Address - Street 1:5 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4305
Practice Address - Country:US
Practice Address - Phone:203-762-5141
Practice Address - Fax:203-762-9011
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2032415Medicaid