Provider Demographics
NPI:1902168966
Name:W.G.DENTAL
Entity Type:Organization
Organization Name:W.G.DENTAL
Other - Org Name:DR.DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-763-7894
Mailing Address - Street 1:8606 NAPA LNDG
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4853
Mailing Address - Country:US
Mailing Address - Phone:956-763-7894
Mailing Address - Fax:
Practice Address - Street 1:10842 POTRANCO RD
Practice Address - Street 2:KOHL'S CENTER, SUITE # 115
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3307
Practice Address - Country:US
Practice Address - Phone:956-763-7894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty