Provider Demographics
NPI:1679114748
Name:SARAH POU DENTAL INC
Entity type:Organization
Organization Name:SARAH POU DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:POU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-972-2506
Mailing Address - Street 1:516 W 17TH ST. STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706
Mailing Address - Country:US
Mailing Address - Phone:714-972-2506
Mailing Address - Fax:714-880-4088
Practice Address - Street 1:516 W 17TH ST. STE A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706
Practice Address - Country:US
Practice Address - Phone:714-972-2506
Practice Address - Fax:714-880-4088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARAH POU DENTAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental