Provider Demographics
NPI:1174694491
Name:SAYLOR, JAMES CARL (DDS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CARL
Last Name:SAYLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-1202
Mailing Address - Country:US
Mailing Address - Phone:605-882-3060
Mailing Address - Fax:605-882-0681
Practice Address - Street 1:1155 4TH ST NE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1202
Practice Address - Country:US
Practice Address - Phone:605-882-3060
Practice Address - Fax:605-882-0681
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM5821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7804510Medicaid