Provider Demographics
NPI:1689419558
Name:SARGIOUS, SELVIA (DDS)
Entity type:Individual
Prefix:DR
First Name:SELVIA
Middle Name:
Last Name:SARGIOUS
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 1:24 LIBERTY LN
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-3362
Mailing Address - Country:US
Mailing Address - Phone:615-482-7013
Mailing Address - Fax:
Practice Address - Street 1:24 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-3362
Practice Address - Country:US
Practice Address - Phone:615-482-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12552122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist