Provider Demographics
NPI:1811392095
Name:MOURAD, SARAH M (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:MOURAD
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 1:841 STONEWALL CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1927
Mailing Address - Country:US
Mailing Address - Phone:732-429-6436
Mailing Address - Fax:
Practice Address - Street 1:1000 MCBRIDE AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2578
Practice Address - Country:US
Practice Address - Phone:973-742-5541
Practice Address - Fax:973-742-5541
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02571700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist