Provider Demographics
NPI:1699824219
Name:SARRIS, JOHN G (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:SARRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 S FEDERAL HWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3325
Mailing Address - Country:US
Mailing Address - Phone:561-278-7450
Mailing Address - Fax:561-278-7434
Practice Address - Street 1:1911 S FEDERAL HWY STE 600
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3325
Practice Address - Country:US
Practice Address - Phone:561-278-7450
Practice Address - Fax:561-278-7434
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBS20616681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice