Provider Demographics
NPI:1699186288
Name:USHER, SARAH ROSE (DMD, MPH)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:USHER
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-4969
Mailing Address - Country:US
Mailing Address - Phone:575-622-4455
Mailing Address - Fax:575-624-2556
Practice Address - Street 1:824 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4969
Practice Address - Country:US
Practice Address - Phone:575-622-4455
Practice Address - Fax:575-624-2556
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMTD-00-62122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist