Provider Demographics
NPI:1447347653
Name:TIMOTHY J. SAUBER D.D.S., LLC
Entity type:Organization
Organization Name:TIMOTHY J. SAUBER D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SAUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-334-3111
Mailing Address - Street 1:600 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3215
Mailing Address - Country:US
Mailing Address - Phone:419-334-3111
Mailing Address - Fax:419-334-6996
Practice Address - Street 1:600 3RD AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3215
Practice Address - Country:US
Practice Address - Phone:419-334-3111
Practice Address - Fax:419-334-6996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty