Provider Demographics
NPI:1760193965
Name:SIERRA L DEMARREE DMD PLLC
Entity Type:Organization
Organization Name:SIERRA L DEMARREE DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARREE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:315-576-3133
Mailing Address - Street 1:67 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SODUS
Mailing Address - State:NY
Mailing Address - Zip Code:14551
Mailing Address - Country:US
Mailing Address - Phone:315-483-8301
Mailing Address - Fax:
Practice Address - Street 1:67 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SODUS
Practice Address - State:NY
Practice Address - Zip Code:14551
Practice Address - Country:US
Practice Address - Phone:315-483-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental