Provider Demographics
NPI:1215208954
Name:LAPRELLE, SASHA E (RDH,LAP,BS)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:E
Last Name:LAPRELLE
Suffix:
Gender:F
Credentials:RDH,LAP,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 S STONEHAM CIR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6353
Mailing Address - Country:US
Mailing Address - Phone:541-261-8018
Mailing Address - Fax:
Practice Address - Street 1:495 S STONEHAM CIR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6353
Practice Address - Country:US
Practice Address - Phone:541-261-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5203124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist