Provider Demographics
NPI:1427015452
Name:WILLIAMS, SARA LYNN
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 DEBARR RD
Mailing Address - Street 2:DENTAL SERVICE
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2983
Mailing Address - Country:US
Mailing Address - Phone:907-257-4940
Mailing Address - Fax:907-257-4953
Practice Address - Street 1:2925 DEBARR RD
Practice Address - Street 2:DENTAL SERVICE
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2983
Practice Address - Country:US
Practice Address - Phone:907-257-4940
Practice Address - Fax:907-257-4953
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7724124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist