Provider Demographics
NPI:1356446330
Name:GOVE, SARAH MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:GOVE
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 1:9717 PINE RIDGE EAST DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2166
Mailing Address - Country:US
Mailing Address - Phone:317-577-2409
Mailing Address - Fax:
Practice Address - Street 1:1251 W KEM RD STE G
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2555
Practice Address - Country:US
Practice Address - Phone:765-664-5164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010556A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice