Provider Demographics
NPI:1689165748
Name:EUGENE SACHAKOV DMD PC
Entity Type:Organization
Organization Name:EUGENE SACHAKOV DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHAOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-287-6715
Mailing Address - Street 1:182 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2931
Mailing Address - Country:US
Mailing Address - Phone:508-287-6715
Mailing Address - Fax:
Practice Address - Street 1:182 ADAMS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-2931
Practice Address - Country:US
Practice Address - Phone:508-287-6715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental