Provider Demographics
NPI:1831454412
Name:LUCE, SARAH THERESE (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:THERESE
Last Name:LUCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:THERESE
Other - Last Name:KNOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-378-8661
Mailing Address - Fax:
Practice Address - Street 1:1000 GREG KRUSCHEK AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0966
Practice Address - Country:US
Practice Address - Phone:907-378-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD150141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice