Provider Demographics
NPI:1306994884
Name:SARAH J. ROBERTS, INC.
Entity type:Organization
Organization Name:SARAH J. ROBERTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-319-0123
Mailing Address - Street 1:12670 CRABAPPLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6402
Mailing Address - Country:US
Mailing Address - Phone:404-431-3862
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:404-431-3862
Practice Address - Fax:678-319-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
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?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty