Provider Demographics
NPI:1255474847
Name:SADDLER, GARY CLINTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:CLINTON
Last Name:SADDLER
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 1:24039 SHOOTING STAR DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9147
Mailing Address - Country:US
Mailing Address - Phone:303-526-1807
Mailing Address - Fax:303-526-5668
Practice Address - Street 1:4901 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2025
Practice Address - Country:US
Practice Address - Phone:303-455-2273
Practice Address - Fax:303-455-6053
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice