Provider Demographics
NPI:1962558007
Name:BETH SAACKS DDS APDC
Entity type:Organization
Organization Name:BETH SAACKS DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAACKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-626-8980
Mailing Address - Street 1:2881 HIGHWAY 190 STE D4
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3248
Mailing Address - Country:US
Mailing Address - Phone:985-626-8980
Mailing Address - Fax:985-727-4660
Practice Address - Street 1:2881 HIGHWAY 190 STE D4
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3248
Practice Address - Country:US
Practice Address - Phone:985-626-8980
Practice Address - Fax:985-727-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA48081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty