Provider Demographics
NPI:1538185194
Name:SAKSHAUG, THOMAS JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:SAKSHAUG
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 1:222 SOUTH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6818
Mailing Address - Country:US
Mailing Address - Phone:413-499-0653
Mailing Address - Fax:
Practice Address - Street 1:222 SOUTH ST
Practice Address - Street 2:SUITE 106
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6818
Practice Address - Country:US
Practice Address - Phone:413-499-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice