Individual
DR. THOMAS PAUL SAGRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2650 BEACH BLVD STE 31, BILOXI, MS 39531-4517
(228) 273-1689
Mailing address
2650 BEACH BLVD STE 31, BILOXI, MS 39531-4517
(228) 273-1689
(228) 388-2051
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3890
AR
1223G0001X
General Practice Dentistry
Primary
4168-20
MS
1223G0001X
General Practice Dentistry
LA3197
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831972
—
LA
01
—
843255
UNITED CONCORDIA
—
01
—
G8132
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/25/2008
Last updated
10/27/2020
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