Provider Demographics
NPI:1912100652
Name:SAENZ, ALBERTO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:SAENZ
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 1:705 ABELIA RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2012
Mailing Address - Country:US
Mailing Address - Phone:803-727-8144
Mailing Address - Fax:
Practice Address - Street 1:733 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-1521
Practice Address - Country:US
Practice Address - Phone:803-259-3497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1505561223G0001X
NC85431223G0001X
SC42951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC65975UMedicare UPIN