Provider Demographics
NPI:1619497088
Name:KELLER, SARAH K (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:K
Last Name:KELLER
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 1:6760 CORPORATE DR STE 270
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5906
Mailing Address - Country:US
Mailing Address - Phone:719-528-8822
Mailing Address - Fax:
Practice Address - Street 1:6760 CORPORATE DR STE 270
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5906
Practice Address - Country:US
Practice Address - Phone:719-528-8822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice