MEDICARE: SARA ARBOR

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	122300000X	Dentist	DS0000010316	TN
2	122300000X	Dentist	DN1858202	MA

General Provider Information

NPI Number	:	1861946097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA ARBOR

Provider Business Mailing Address
First Line	:	255 PARK AVE STE 509
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1989
Country	:	US
Telephone Number	:	413-687-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 PARK AVE STE 509
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1989
Country	:	US
Telephone Number	:	413-687-5208
Fax Number	:

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

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	05/18/2019

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Directions to “ SARA ARBOR ” Practice Location

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