Provider Demographics
NPI:1114903606
Name:KNOELL, SARA KATHLEEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:KATHLEEN
Last Name:KNOELL
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 1:136 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2323
Mailing Address - Country:US
Mailing Address - Phone:731-435-1253
Mailing Address - Fax:731-435-1254
Practice Address - Street 1:136 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2323
Practice Address - Country:US
Practice Address - Phone:731-435-1253
Practice Address - Fax:731-435-1254
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7951122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist