Healthcare Provider Details

I. General information

NPI: 1184534208
Provider Name (Legal Business Name): SAHARRA EUBANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 GECK RD
PALATKA FL
32177-9619
US

IV. Provider business mailing address

124 GECK RD
PALATKA FL
32177-9619
US

V. Phone/Fax

Practice location:
  • Phone: 386-916-2648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH33651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: