Provider Demographics
NPI:1881421451
Name:MARCINE, SARA (DDS)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:MARCINE
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 1:330 E 400 S APT 746
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3065
Mailing Address - Country:US
Mailing Address - Phone:807-407-7272
Mailing Address - Fax:
Practice Address - Street 1:850 E 300 S STE 7
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2393
Practice Address - Country:US
Practice Address - Phone:385-707-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14167843-99261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice