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General NPI Number Information
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NPI Number | 1699186288
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Entity Type | Individual
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Provider Name | SARAH ROSE USHER DMD, MPH
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Gender | Female
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 824 N MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88201-4969
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Country | US
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Telephone | 575-622-4455
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Fax | 575-624-2556
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Provider Business Mailing Address
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Address Line | 824 N MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88201-4969
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Country | US
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Telephone | 575-622-4455
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Fax | 575-624-2556
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | TD-00-62
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License Number State | NM
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