Provider Demographics
NPI:1265662902
Name:WILLMANN, SARAH L (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:L
Last Name:WILLMANN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 MEADOWVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1132
Mailing Address - Country:US
Mailing Address - Phone:419-586-4738
Mailing Address - Fax:419-586-5222
Practice Address - Street 1:1304 MEADOWVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1132
Practice Address - Country:US
Practice Address - Phone:419-586-4738
Practice Address - Fax:419-586-5222
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023069122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist