Provider Demographics
NPI:1174603302
Name:GARRISON, SACHEEN N (DDS)
Entity type:Individual
Prefix:
First Name:SACHEEN
Middle Name:N
Last Name:GARRISON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 SLATE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7280
Mailing Address - Country:US
Mailing Address - Phone:614-863-9775
Mailing Address - Fax:
Practice Address - Street 1:645 MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-1420
Practice Address - Country:US
Practice Address - Phone:614-836-0500
Practice Address - Fax:614-836-6061
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice