Provider Demographics
NPI:1689732331
Name:SABIA, VINCENT GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:GREGORY
Last Name:SABIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-1817
Mailing Address - Country:US
Mailing Address - Phone:716-826-4050
Mailing Address - Fax:716-826-0191
Practice Address - Street 1:1188 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-1817
Practice Address - Country:US
Practice Address - Phone:716-826-4050
Practice Address - Fax:716-826-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041441-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice