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General NPI Number Information
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NPI Number | 1699597740
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Entity Type | Individual
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Provider Name | SARA KILLACKEY-SEAVER
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 4 KEITH WAY STE 3
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City | HINGHAM
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State | MA
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Zip | 02043-4258
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Country | US
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Telephone | 781-608-8838
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Fax |
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Provider Business Mailing Address
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Address Line | 200 FALLS BLVD UNIT D309
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City | QUINCY
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State | MA
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Zip | 02169-8190
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Country | US
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Telephone | 857-389-7706
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH89452
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License Number State | MA
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