MEDICARE: DR. SARA ANN GASAWAY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	60739	KS

General Provider Information

NPI Number	:	1699082180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA ANN GASAWAY D.D.S.

Provider Business Mailing Address
First Line	:	401 S CLAIRBORNE RD
Second Line	:	SUITE A
City	:	OLATHE
State	:	KS
Zip	:	66062-1735
Country	:	US
Telephone Number	:	913-782-2231
Fax Number	:	913-782-2246

Provider Business Practice Location Address
First Line	:	401 S CLAIRBORNE RD
Second Line	:	SUITE A
City	:	OLATHE
State	:	KS
Zip	:	66062-1735
Country	:	US
Telephone Number	:	913-782-2231
Fax Number	:	913-782-2246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2010
Last Update Date	:	09/07/2010

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