Provider Demographics
NPI:1477816056
Name:SMITH, SARAH MAREE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MAREE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 FAIRFIELD COMMONS BLVD
Mailing Address - Street 2:DAYTON DENTAL AND ORTHODONTICS
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431
Mailing Address - Country:US
Mailing Address - Phone:937-431-0947
Mailing Address - Fax:
Practice Address - Street 1:2727 FAIRFIELD COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3778
Practice Address - Country:US
Practice Address - Phone:937-431-0947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023761122300000X, 1223X0400X
IN12011790A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist