Provider Demographics
NPI:1629147376
Name:SAKATA, MARLIN K (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARLIN
Middle Name:K
Last Name:SAKATA
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 1:4111 BRIDGEPORT WAY WEST
Mailing Address - Street 2:SUITE A
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466
Mailing Address - Country:US
Mailing Address - Phone:253-582-9103
Mailing Address - Fax:253-460-3082
Practice Address - Street 1:4111 BRIDGEPORT WAY WEST
Practice Address - Street 2:SUITE A
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466
Practice Address - Country:US
Practice Address - Phone:253-582-9103
Practice Address - Fax:253-460-3082
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE69051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice