Provider Demographics
NPI:1144470717
Name:SACREY, JAMES BRAMLETT JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRAMLETT
Last Name:SACREY
Suffix:JR
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 1:328 ANDERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1206
Mailing Address - Country:US
Mailing Address - Phone:630-232-0659
Mailing Address - Fax:
Practice Address - Street 1:328 ANDERSON BLVD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1206
Practice Address - Country:US
Practice Address - Phone:630-232-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.013447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist