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Individual
SARA DAVIDSON
Active
Individual
SARA DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
058817-1
NY
1223G0001X
General Practice Dentistry
Primary
101222
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2015
Last updated
12/05/2020
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