Provider Demographics
NPI:1699733931
Name:SARNO, MICHELLE USON (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:USON
Last Name:SARNO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:D
Other - Last Name:USON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3636 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6626
Mailing Address - Country:US
Mailing Address - Phone:706-869-9117
Mailing Address - Fax:706-869-8836
Practice Address - Street 1:9398 VISCOUNT BLVD STE 4B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-8028
Practice Address - Country:US
Practice Address - Phone:915-595-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0155251223E0200X
SC41971223G0001X
TX391731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice