Individual
ASHLEY P SARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3209 W BAVARIA ST, EAGLE, ID 83616-5171
(208) 855-0080
Mailing address
13720 OLD SAINT AUGUSTINE RD, #5, JACKSONVILLE, FL 32258-7414
(904) 292-1002
(904) 292-1004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN20190
FL
1223G0001X
General Practice Dentistry
Primary
D-5119
ID
Other
Enumeration date
06/21/2013
Last updated
06/24/2024
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