Provider Demographics
NPI:1144683673
Name:JAY SAWYER DDS PC
Entity type:Organization
Organization Name:JAY SAWYER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:TOM
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:308-236-5922
Mailing Address - Street 1:3020 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-3503
Mailing Address - Country:US
Mailing Address - Phone:308-236-5922
Mailing Address - Fax:
Practice Address - Street 1:3020 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3503
Practice Address - Country:US
Practice Address - Phone:308-236-5922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4581261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental