Provider Demographics
NPI:1306994264
Name:ROBERTS, SARAH (DMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12670 CRABAPPLE ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:678-319-0123
Mailing Address - Fax:678-319-1022
Practice Address - Street 1:12670 CRABAPPLE RD STE 110
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-6402
Practice Address - Country:US
Practice Address - Phone:678-319-0123
Practice Address - Fax:678-319-1022
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0123181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice