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General NPI Number Information
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NPI Number | 1043812076
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Entity Type | Individual
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Provider Name | STEFANIE DAWOOD HANNA SARRA DMD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 7506 N NAVARRO ST
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City | VICTORIA
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State | TX
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Zip | 77904-2654
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Country | US
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Telephone | 361-489-3304
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Fax |
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Provider Business Mailing Address
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Address Line | 13311 MANDY LN
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City | SANTA FE
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State | TX
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Zip | 77510-7217
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Country | US
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Telephone | 619-212-3291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36827
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License Number State | TX
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