Healthcare Provider Details

I. General information

NPI: 1487883815
Provider Name (Legal Business Name): SARA KHALED AKEEL D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SAINT ANDREWS DRIVE
AUGUSTA GA
30909
US

IV. Provider business mailing address

705 SAINT ANDREWS DR
AUGUSTA GA
30909-7807
US

V. Phone/Fax

Practice location:
  • Phone: 706-267-7534
  • Fax:
Mailing address:
  • Phone: 706-267-7534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number4032
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: