Provider Demographics
NPI:1316246341
Name:WILSEY, SARAH (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WILSEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E PACES FERRY RD NE
Mailing Address - Street 2:SUITE 611
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2367
Mailing Address - Country:US
Mailing Address - Phone:404-261-3091
Mailing Address - Fax:
Practice Address - Street 1:309 E PACES FERRY RD NE
Practice Address - Street 2:SUITE 611
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2367
Practice Address - Country:US
Practice Address - Phone:404-261-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist