Provider Demographics
NPI:1710331806
Name:BREWER, SARAH LYNN (RDHAP)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LYNN
Last Name:BREWER
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 BRISA BLANDA DR
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-5504
Mailing Address - Country:US
Mailing Address - Phone:805-440-5537
Mailing Address - Fax:805-270-4454
Practice Address - Street 1:2734 BRISA BLANDA DR
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-5504
Practice Address - Country:US
Practice Address - Phone:805-440-5537
Practice Address - Fax:805-270-4454
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH 24763124Q00000X
CAHAP 609124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist