Provider Demographics
NPI:1992258909
Name:GAGE DENTAL SANGER, PLLC
Entity type:Organization
Organization Name:GAGE DENTAL SANGER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-458-9000
Mailing Address - Street 1:551 N STEMMONS ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-9307
Mailing Address - Country:US
Mailing Address - Phone:940-458-9000
Mailing Address - Fax:
Practice Address - Street 1:551 N STEMMONS ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-9307
Practice Address - Country:US
Practice Address - Phone:940-458-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193171223G0001X
TX283331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1275612863OtherINDIVIDUAL NPI