Individual
DR. MAKOTO SAIGUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D, M.D.
Contact information
Practice address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 592-6595
Mailing address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 592-6595
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19097
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
19097
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
K0551
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090187801
—
TX
05
—
090187802
—
TX
05
—
090187803
—
TX
05
—
090187804
—
TX
01
—
133237107
CSHCN
TX
Enumeration date
08/30/2006
Last updated
02/23/2023
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