Provider Demographics
NPI:1003550377
Name:PAGE, SABINE ELIZABETH (DMD)
Entity type:Individual
Prefix:DR
First Name:SABINE
Middle Name:ELIZABETH
Last Name:PAGE
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 1:3602 KNERR DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-2104
Mailing Address - Country:US
Mailing Address - Phone:917-224-7103
Mailing Address - Fax:
Practice Address - Street 1:625 N MAPLE AVE STE 2
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1590
Practice Address - Country:US
Practice Address - Phone:201-670-9076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02896700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist