Provider Demographics
NPI:1376558031
Name:SARAZIN DENTAL PC
Entity Type:Organization
Organization Name:SARAZIN DENTAL PC
Other - Org Name:JAMES W SARAZIN DDS PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SARAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:906-482-8601
Mailing Address - Street 1:528 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930
Mailing Address - Country:US
Mailing Address - Phone:906-482-8601
Mailing Address - Fax:906-482-9953
Practice Address - Street 1:528 QUINCY ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930
Practice Address - Country:US
Practice Address - Phone:906-482-8601
Practice Address - Fax:906-482-9953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901011347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty