Provider Demographics
NPI:1326454430
Name:MURTAZA M. SAJAN DDS INC PS
Entity Type:Organization
Organization Name:MURTAZA M. SAJAN DDS INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MURTAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-732-1023
Mailing Address - Street 1:3104 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-3330
Mailing Address - Country:US
Mailing Address - Phone:414-732-1023
Mailing Address - Fax:
Practice Address - Street 1:3104 S UNION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-3330
Practice Address - Country:US
Practice Address - Phone:414-732-1023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60463430122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty