Provider Demographics
NPI:1467748061
Name:OLIM, SARAH NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:NICOLE
Last Name:OLIM
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 1:1615 S FRY RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6404
Mailing Address - Country:US
Mailing Address - Phone:281-492-6546
Mailing Address - Fax:281-492-0799
Practice Address - Street 1:1615 S FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6404
Practice Address - Country:US
Practice Address - Phone:281-492-6546
Practice Address - Fax:281-492-0799
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice