Provider Demographics
NPI:1295130888
Name:ARROWHEAD FAMILY DENTISTRY
Entity type:Organization
Organization Name:ARROWHEAD FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASEEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-800-3344
Mailing Address - Street 1:407 S E ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-2012
Mailing Address - Country:US
Mailing Address - Phone:909-800-4433
Mailing Address - Fax:
Practice Address - Street 1:26214 REDLANDS BLVD APT 9
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7720
Practice Address - Country:US
Practice Address - Phone:909-800-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty