Provider Demographics
NPI:1982723144
Name:SWEETWATER DENTAL WELLNESS
Entity Type:Organization
Organization Name:SWEETWATER DENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-862-3181
Mailing Address - Street 1:901 WEKIVA SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-2501
Mailing Address - Country:US
Mailing Address - Phone:407-862-3181
Mailing Address - Fax:407-682-7537
Practice Address - Street 1:901 WEKIVA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-2501
Practice Address - Country:US
Practice Address - Phone:407-862-3181
Practice Address - Fax:407-682-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty