Healthcare Provider Details

I. General information

NPI: 1134212855
Provider Name (Legal Business Name): JOLANTA SAUER DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 SPRINGHURST BLVD. SUITE 108 SPRINGHURST ENDODONTICS
LOUISVILLE KY
40241-0001
US

IV. Provider business mailing address

3801 SPRINGHURST BLVD. SUITE 108 SPRINGHURST ENDODONTICS
LOUISVILLE KY
40241-0001
US

V. Phone/Fax

Practice location:
  • Phone: 502-618-1200
  • Fax: 502-618-1205
Mailing address:
  • Phone: 502-618-1200
  • Fax: 502-618-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number8260
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: