Provider Demographics
NPI:1467688267
Name:SQUIRES, SARAH ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:WESTBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:4931 N BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53563-8893
Mailing Address - Country:US
Mailing Address - Phone:608-770-6820
Mailing Address - Fax:
Practice Address - Street 1:258 CORPORATE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-2407
Practice Address - Country:US
Practice Address - Phone:608-770-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6351-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice