Provider Demographics
NPI:1386872521
Name:AZA, SARA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:MARIA
Last Name:AZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11501 LAKESIDE DR APT 6204
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3024
Mailing Address - Country:US
Mailing Address - Phone:786-266-1753
Mailing Address - Fax:
Practice Address - Street 1:8351 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7454
Practice Address - Country:US
Practice Address - Phone:786-266-1753
Practice Address - Fax:954-341-7272
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN187301223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry