Provider Demographics
NPI:1982834925
Name:SACKHEIM, WILLIAM ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ERIC
Last Name:SACKHEIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4627 NORTH DAVIS HWY
Mailing Address - Street 2:BUILDING B
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503
Mailing Address - Country:US
Mailing Address - Phone:850-377-8759
Mailing Address - Fax:
Practice Address - Street 1:4627 N DAVIS HWY
Practice Address - Street 2:BUILDING B
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2364
Practice Address - Country:US
Practice Address - Phone:850-476-2602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 186971223G0001X
NMDD33951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice