Provider Demographics
NPI:1730495086
Name:HABASHI, SARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:HABASHI
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 1:5651 CORPORATE WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2020
Mailing Address - Country:US
Mailing Address - Phone:561-689-0872
Mailing Address - Fax:561-683-9262
Practice Address - Street 1:6772 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3322
Practice Address - Country:US
Practice Address - Phone:561-966-3531
Practice Address - Fax:561-966-6388
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17134122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist