Provider Demographics
NPI:1710112495
Name:WITHROW, SARAH MICHELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MICHELLE
Last Name:WITHROW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1774
Mailing Address - Country:US
Mailing Address - Phone:256-461-4184
Mailing Address - Fax:256-461-7892
Practice Address - Street 1:119 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1774
Practice Address - Country:US
Practice Address - Phone:256-337-1147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-24
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD5645122300000X
MO20090125011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice