Provider Demographics
NPI:1497949713
Name:SAYWARD E. DUGGAN DDS MS PC
Entity Type:Organization
Organization Name:SAYWARD E. DUGGAN DDS MS PC
Other - Org Name:YORKTOWN PERIODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYWARD
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:DUGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:757-874-1777
Mailing Address - Street 1:4310 GEORGE WASHINGTON MEMORIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692
Mailing Address - Country:US
Mailing Address - Phone:757-874-1777
Mailing Address - Fax:
Practice Address - Street 1:4310 GEORGE WASHINGTON MEMORIAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692
Practice Address - Country:US
Practice Address - Phone:757-874-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006503261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000880911OtherUNITED CONCORDIA