Provider Demographics
NPI:1043833148
Name:EASTON, SARAH JUNE (DMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JUNE
Last Name:EASTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-2621
Mailing Address - Country:US
Mailing Address - Phone:440-226-1535
Mailing Address - Fax:
Practice Address - Street 1:157 CARROLL AVE
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-2621
Practice Address - Country:US
Practice Address - Phone:440-226-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0261491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice