Individual
DR. SAGE MONROE HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
725 W LA VETA AVE STE 120, ORANGE, CA 92868-4445
(714) 997-5961
Mailing address
725 W LA VETA AVE STE 120, ORANGE, CA 92868-4445
(714) 997-5961
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
53072
CA
305R00000X
Preferred Provider Organization
Primary
53072
CA
Other
Enumeration date
04/18/2007
Last updated
11/15/2011
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