Provider Demographics
NPI:1083281257
Name:SAFFORD, AUSTIN DANIEL (DDS)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:DANIEL
Last Name:SAFFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 BAYOU BENGAL CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-8445
Mailing Address - Country:US
Mailing Address - Phone:225-571-5008
Mailing Address - Fax:
Practice Address - Street 1:610 N RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2934
Practice Address - Country:US
Practice Address - Phone:225-665-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice