Provider Demographics
NPI:1962812305
Name:GLASS, SARAH H (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:H
Last Name:GLASS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:520 NORTH 12TH STREET
Mailing Address - Street 2:SUITE 215
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:804-828-1778
Mailing Address - Fax:804-628-2001
Practice Address - Street 1:520 NORTH 12TH STREET
Practice Address - Street 2:SUITE 315
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298
Practice Address - Country:US
Practice Address - Phone:804-828-1778
Practice Address - Fax:804-628-2001
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
VA04014154511223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program