Basic Information
| Provider Information | |||||||||
| NPI: | 1851378707 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAFTON | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 SHENANGO AVE | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161461503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247048886 | ||||||||
| FaxNumber: | 7243421942 | ||||||||
| Practice Location | |||||||||
| Address1: | 1302 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | BEAVER FALLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150104217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7248434400 | ||||||||
| FaxNumber: | 7248438728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2005 | ||||||||
| LastUpdateDate: | 07/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DS031611L | PA | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | 0019507860001 | 05 | PA | MEDICAID | 2411232 | 05 | OH | MEDICAID |