Provider Demographics
NPI:1437196847
Name:SAWISCH, TODD JASON (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:JASON
Last Name:SAWISCH
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 1:2161 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3810
Mailing Address - Country:US
Mailing Address - Phone:954-772-2000
Mailing Address - Fax:954-772-0614
Practice Address - Street 1:2161 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3810
Practice Address - Country:US
Practice Address - Phone:954-772-2000
Practice Address - Fax:954-772-0614
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7169911223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology