Provider Demographics
NPI:1831177369
Name:SAYEGH, ANTOINE S (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:S
Last Name:SAYEGH
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 1:707 W ROUTE 66
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4134
Mailing Address - Country:US
Mailing Address - Phone:626-963-7581
Mailing Address - Fax:626-963-2847
Practice Address - Street 1:707 W ROUTE 66
Practice Address - Street 2:SUITE 102
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4134
Practice Address - Country:US
Practice Address - Phone:626-963-7581
Practice Address - Fax:626-963-2847
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407251223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics