Provider Demographics
NPI:1700028024
Name:KNAPP, SARRETTA ANN
Entity Type:Individual
Prefix:MRS
First Name:SARRETTA
Middle Name:ANN
Last Name:KNAPP
Suffix:
Gender:F
Credentials:
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 644
Mailing Address - Street 2:
Mailing Address - City:LOYALTON
Mailing Address - State:CA
Mailing Address - Zip Code:96118-0644
Mailing Address - Country:US
Mailing Address - Phone:530-993-4386
Mailing Address - Fax:
Practice Address - Street 1:6770 S MCCARRAN
Practice Address - Street 2:SUITE 102
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6176
Practice Address - Country:US
Practice Address - Phone:775-770-3591
Practice Address - Fax:775-770-6110
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3291124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist