Provider Demographics
NPI:1841673399
Name:GAALAAS, SARA A (DDS, ORTHODONTIST)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:GAALAAS
Suffix:
Gender:F
Credentials:DDS, ORTHODONTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 NW 1ST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-2663
Mailing Address - Country:US
Mailing Address - Phone:218-326-0377
Mailing Address - Fax:218-326-0378
Practice Address - Street 1:504 NW 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-2663
Practice Address - Country:US
Practice Address - Phone:218-326-0377
Practice Address - Fax:218-326-0378
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND135541223X0400X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist