Provider Demographics
NPI:1386929545
Name:STRATTON, SARAH ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:STRATTON
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 1:301 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-1841
Mailing Address - Country:US
Mailing Address - Phone:812-386-6677
Mailing Address - Fax:812-385-5473
Practice Address - Street 1:301 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1841
Practice Address - Country:US
Practice Address - Phone:812-386-6677
Practice Address - Fax:812-385-5473
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011749A122300000X
IN390200000X122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201042010AMedicaid
IN002679140OtherUNITED CONCORDIA