Provider Demographics
NPI:1083892889
Name:RIECHERS, SARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:RIECHERS
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 1:568 NE E ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2326
Mailing Address - Country:US
Mailing Address - Phone:541-956-2177
Mailing Address - Fax:541-476-0491
Practice Address - Street 1:568 NE E ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2326
Practice Address - Country:US
Practice Address - Phone:541-956-2177
Practice Address - Fax:541-476-0491
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00011201122300000X
ORD9109122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist