Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 26045 | TX |
N | 1223P0221X | Pediatric Dentist | 59164 | CA |
NPI | 1083926174 |
---|---|
Provider Name | Dr. Dana Marie Saucier |
First Address | Austin, TX 78704-6074 |
Second Address | Austin, TX 78704-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D26045 | (05) | TX |