Provider Demographics
NPI:1821315870
Name:BETH SAACKS, D.D.S. & ASSOCIATES
Entity Type:Organization
Organization Name:BETH SAACKS, D.D.S. & ASSOCIATES
Other - Org Name:FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAACKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-626-8980
Mailing Address - Street 1:2881 HIGHWAY 190
Mailing Address - Street 2:SUITE D-4
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3248
Mailing Address - Country:US
Mailing Address - Phone:985-626-8980
Mailing Address - Fax:985-727-4660
Practice Address - Street 1:2881 HIGHWAY 190
Practice Address - Street 2:SUITE D-4
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3248
Practice Address - Country:US
Practice Address - Phone:985-626-8980
Practice Address - Fax:985-727-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LANOT 10520-01223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty