Provider Demographics
NPI:1548706492
Name:SAROJ KUMAR SAHA DDS MSD
Entity type:Organization
Organization Name:SAROJ KUMAR SAHA DDS MSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAROJ
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SAHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:309-657-6665
Mailing Address - Street 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 450 EAST TOWER
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2803
Mailing Address - Country:US
Mailing Address - Phone:309-657-6665
Mailing Address - Fax:303-741-2777
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 450 EAST TOWER
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:309-657-6665
Practice Address - Fax:303-741-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COD002020851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty