Provider Demographics
NPI:1023145026
Name:SATOW, SARAH J (BSC, DMD, FRCDC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:SATOW
Suffix:
Gender:F
Credentials:BSC, DMD, FRCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 MINNIE ST.,
Mailing Address - Street 2:SUITE D
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701
Mailing Address - Country:US
Mailing Address - Phone:907-455-4010
Mailing Address - Fax:
Practice Address - Street 1:114 MINNIE ST.,
Practice Address - Street 2:SUITE D
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-455-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-3754-OS1223S0112X
WADE 000077631223S0112X
AK1641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8804449Medicare ID - Type Unspecified