Provider Demographics
NPI:1134124712
Name:SAAL, CHRISTOPHER JOHN (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:SAAL
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 POLK ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-6011
Mailing Address - Country:US
Mailing Address - Phone:985-879-1972
Mailing Address - Fax:985-879-4661
Practice Address - Street 1:1608 POLK ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-6011
Practice Address - Country:US
Practice Address - Phone:985-879-1972
Practice Address - Fax:985-879-4661
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021634204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1840050Medicaid
LAF65659Medicare UPIN
LA1840050Medicaid