Healthcare Provider Details

I. General information

NPI: 1760346399
Provider Name (Legal Business Name): SARAH A SMITH DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 JUNGERMANN RD
SAINT PETERS MO
63376-5350
US

IV. Provider business mailing address

322 JUNGERMANN RD
SAINT PETERS MO
63376-5350
US

V. Phone/Fax

Practice location:
  • Phone: 636-477-1200
  • Fax:
Mailing address:
  • Phone: 636-477-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SARAH SMITH
Title or Position: PRESIDENT
Credential: DDS
Phone: 636-477-1200