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General NPI Number Information
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NPI Number | 1073067963
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Entity Type | Individual
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Provider Name | SARA FATIMA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 380 BUTTERFLY GARDENS DR
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City | COLUMBUS
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State | OH
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Zip | 43215-7508
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Country | US
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Telephone | 614-355-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 19 BARBIERI CT
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City | PRINCETON
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State | NJ
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Zip | 08540-8599
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Country | US
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Telephone | 217-361-7647
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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 | 019030879
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License Number State | IL
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