Provider Demographics
NPI:1083926174
Name:SAUCIER, DANA MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:SAUCIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:KOSSICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:555 RIVER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4132
Mailing Address - Country:US
Mailing Address - Phone:423-558-3082
Mailing Address - Fax:423-558-2744
Practice Address - Street 1:555 RIVER ST STE 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4132
Practice Address - Country:US
Practice Address - Phone:423-558-3082
Practice Address - Fax:423-558-2744
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260451223P0221X
TN116551223P0221X
CA591641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ069380Medicaid