Provider Demographics
NPI:1043444128
Name:SABOTT, DAVID G
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:SABOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3102
Mailing Address - Country:US
Mailing Address - Phone:720-682-0153
Mailing Address - Fax:720-685-3453
Practice Address - Street 1:503 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3102
Practice Address - Country:US
Practice Address - Phone:720-682-0153
Practice Address - Fax:720-685-3453
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO005151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics