Provider Demographics
NPI:1922408699
Name:CARHOUN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CARHOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:CARHOUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:W241 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:STEPHENSON
Mailing Address - State:MI
Mailing Address - Zip Code:49887-8952
Mailing Address - Country:US
Mailing Address - Phone:231-250-4990
Mailing Address - Fax:
Practice Address - Street 1:W241 DIVISION ST
Practice Address - Street 2:
Practice Address - City:STEPHENSON
Practice Address - State:MI
Practice Address - Zip Code:49887-8952
Practice Address - Country:US
Practice Address - Phone:231-250-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902016676124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist