Provider Demographics
NPI:1073860052
Name:TOVAR, SARAH NICOLE PERCY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:NICOLE PERCY
Last Name:TOVAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:NICOLE
Other - Last Name:PERCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4118 MCCULLOUGH AVE.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-826-8492
Mailing Address - Fax:210-826-4313
Practice Address - Street 1:4118 MCCULLOUGH AVE.
Practice Address - Street 2:SUITE 6
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212
Practice Address - Country:US
Practice Address - Phone:210-826-8492
Practice Address - Fax:210-826-4313
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283081223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice