Provider Demographics
NPI:1871046235
Name:LATIF, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LATIF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6890 E SUNRISE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-0739
Mailing Address - Country:US
Mailing Address - Phone:520-966-8376
Mailing Address - Fax:
Practice Address - Street 1:6890 E SUNRISE DR STE 120
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-0739
Practice Address - Country:US
Practice Address - Phone:520-966-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0095681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice