Provider Demographics
NPI:1093822934
Name:SAUK, ERIC M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:SAUK
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 1:1401 N TUSTIN AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8644
Mailing Address - Country:US
Mailing Address - Phone:714-664-0200
Mailing Address - Fax:714-664-0479
Practice Address - Street 1:4420 DIXIE HWY STE 110
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2986
Practice Address - Country:US
Practice Address - Phone:502-447-3323
Practice Address - Fax:913-752-9116
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice