Provider Demographics
NPI:1518183466
Name:SAILUS, JOSEPH J (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:SAILUS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 STATE ROUTE 611
Mailing Address - Street 2:BARTONSVILLE COMMONS SUITE #4
Mailing Address - City:BARTONSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18321
Mailing Address - Country:US
Mailing Address - Phone:570-629-8001
Mailing Address - Fax:570-629-8821
Practice Address - Street 1:102 STATE ROUTE 611
Practice Address - Street 2:BARTONSVILLE COMMONS SUITE #4
Practice Address - City:BARTONSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18321
Practice Address - Country:US
Practice Address - Phone:570-629-8001
Practice Address - Fax:570-629-8821
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021979L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics