Provider Demographics
NPI:1093358301
Name:FALERIS, SARAH THERESA (CDA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:THERESA
Last Name:FALERIS
Suffix:
Gender:F
Credentials:CDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SANDLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-6129
Mailing Address - Country:US
Mailing Address - Phone:856-739-2366
Mailing Address - Fax:
Practice Address - Street 1:15 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1613
Practice Address - Country:US
Practice Address - Phone:856-465-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ248768126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant