MEDICARE: SARA MARTIN

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	124Q00000X	Dental Hygienist	RDH3991	ME

General Provider Information

NPI Number	:	1881083913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MARTIN

Provider Business Mailing Address
First Line	:	460 WALDOBORO RD
Second Line	:
City	:	WASHINGTON
State	:	ME
Zip	:	04574-3202
Country	:	US
Telephone Number	:	215-605-7432
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 WALDOBORO RD
Second Line	:
City	:	WASHINGTON
State	:	ME
Zip	:	04574-3202
Country	:	US
Telephone Number	:	215-605-7432
Fax Number	:

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

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	01/13/2015

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Directions to “ SARA MARTIN ” Practice Location

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