Provider Demographics
NPI:1275938789
Name:SAGMAN, ASEEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASEEL
Middle Name:A
Last Name:SAGMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2274
Mailing Address - Country:US
Mailing Address - Phone:909-237-6005
Mailing Address - Fax:909-440-9003
Practice Address - Street 1:1568 ORANGE ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2274
Practice Address - Country:US
Practice Address - Phone:909-237-6005
Practice Address - Fax:909-440-9003
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist