Provider Demographics
NPI:1376855437
Name:ROLLOR, SARAH ROSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ROSE
Last Name:ROLLOR
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 1:2700 LIGHTHOUSE PT E
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4777
Mailing Address - Country:US
Mailing Address - Phone:410-675-3300
Mailing Address - Fax:
Practice Address - Street 1:2700 LIGHTHOUSE PT E
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4777
Practice Address - Country:US
Practice Address - Phone:410-675-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD14799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program