Provider Demographics
NPI:1427743368
Name:FRUSCIONE, SARAH ROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ROSE
Last Name:FRUSCIONE
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 1:2632 N WILSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2275
Mailing Address - Country:US
Mailing Address - Phone:847-502-3012
Mailing Address - Fax:
Practice Address - Street 1:18340 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2910
Practice Address - Country:US
Practice Address - Phone:708-799-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program