Provider Demographics
NPI:1659493294
Name:BREVET, SARAH C (DMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:BREVET
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 1:64 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07756-1319
Mailing Address - Country:US
Mailing Address - Phone:732-774-8700
Mailing Address - Fax:732-774-8708
Practice Address - Street 1:64 MAIN AVE
Practice Address - Street 2:
Practice Address - City:OCEAN GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07756-1319
Practice Address - Country:US
Practice Address - Phone:732-774-8700
Practice Address - Fax:732-774-8708
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021523001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice