Provider Demographics
NPI:1508160599
Name:SAGE, JAMIE GAIL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:GAIL
Last Name:SAGE
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Gender:F
Credentials:DDS, MS
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Mailing Address - Street 1:3275 COOLEY CT
Mailing Address - Street 2:SUITE 155
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7433
Mailing Address - Country:US
Mailing Address - Phone:269-327-0760
Mailing Address - Fax:269-327-0765
Practice Address - Street 1:3275 COOLEY CT
Practice Address - Street 2:SUITE 155
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-7433
Practice Address - Country:US
Practice Address - Phone:269-327-0760
Practice Address - Fax:269-327-0765
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-02-17
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Provider Licenses
StateLicense IDTaxonomies
MI29010196591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics