Provider Demographics
NPI:1245611862
Name:SACHS, EVAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:SACHS
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 1:3133 S TELEGRAPH RD
Mailing Address - Street 2:STE 1
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3472
Mailing Address - Country:US
Mailing Address - Phone:248-762-1921
Mailing Address - Fax:
Practice Address - Street 1:3133 S TELEGRAPH RD
Practice Address - Street 2:STE 1
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3472
Practice Address - Country:US
Practice Address - Phone:248-762-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist