Provider Demographics
NPI:1891809075
Name:SAFFOLD, STEPHEN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PATRICK
Last Name:SAFFOLD
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 1:925 SECRET RIVER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3465
Mailing Address - Country:US
Mailing Address - Phone:916-391-2888
Mailing Address - Fax:916-391-3245
Practice Address - Street 1:925 SECRET RIVER DR
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3465
Practice Address - Country:US
Practice Address - Phone:916-391-2888
Practice Address - Fax:916-391-3245
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice