Provider Demographics
NPI:1518112739
Name:STEIEN, SARA JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:JO
Last Name:STEIEN
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:PO BOX 11
Mailing Address - Street 2:601 THIRD STREET
Mailing Address - City:MELROSE
Mailing Address - State:WI
Mailing Address - Zip Code:54642-0011
Mailing Address - Country:US
Mailing Address - Phone:414-587-2864
Mailing Address - Fax:
Practice Address - Street 1:601 3RD ST
Practice Address - Street 2:601 THIRD STREET
Practice Address - City:MELROSE
Practice Address - State:WI
Practice Address - Zip Code:54642-7240
Practice Address - Country:US
Practice Address - Phone:414-587-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9331122300000X
WI6001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist