Provider Demographics
NPI:1902180565
Name:BRET W SAUDERS DDS, INC
Entity Type:Organization
Organization Name:BRET W SAUDERS DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SAUDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-473-9501
Mailing Address - Street 1:PO BOX 2193
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-0039
Mailing Address - Country:US
Mailing Address - Phone:817-473-9501
Mailing Address - Fax:817-473-9501
Practice Address - Street 1:1600 US HWY 287 N. #102
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2874
Practice Address - Country:US
Practice Address - Phone:817-473-9501
Practice Address - Fax:817-473-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty