Provider Demographics
NPI:1619016508
Name:SAIDON, YAACOV (DMD)
Entity Type:Individual
Prefix:DR
First Name:YAACOV
Middle Name:
Last Name:SAIDON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:JACOB
Other - Middle Name:
Other - Last Name:SAIDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:231 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1915
Mailing Address - Country:US
Mailing Address - Phone:860-284-1032
Mailing Address - Fax:860-284-9067
Practice Address - Street 1:231 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1915
Practice Address - Country:US
Practice Address - Phone:860-284-1032
Practice Address - Fax:860-284-9067
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081771223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics