Healthcare Provider Details

I. General information

NPI: 1801184478
Provider Name (Legal Business Name): SARA TWARDY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 WINDY HILL ROAD SE SUITE 220
SMYRNA GA
30080
US

IV. Provider business mailing address

214 COLONIAL HOMES DR NW UNIT 1343
ATLANTA GA
30309-1583
US

V. Phone/Fax

Practice location:
  • Phone: 770-302-0504
  • Fax:
Mailing address:
  • Phone: 334-444-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN014316
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN014316
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: