Provider Demographics
NPI:1609217470
Name:BOREN, SARA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:B
Last Name:BOREN
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 1:122 LYNNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3306
Mailing Address - Country:US
Mailing Address - Phone:865-687-9350
Mailing Address - Fax:
Practice Address - Street 1:122 LYNNWOOD DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-3306
Practice Address - Country:US
Practice Address - Phone:865-687-9350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN98731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice