Sara Elizabeth Brooks, RDH, BS

Individual provider Active NPI Dental Hygienist · Hannibal, MO

NPI 1760065494 · NPPES record last updated Apr 30, 2021

Key facts

NPI
1760065494
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
2013031274 (MO)
Practice address
9126 Idell Creek LN
Hannibal, MO 63401-6458
Phone
(217) 231-1179
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2013031274MOMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2013031274 MO Yes

Addresses

Primary practice location

9126 Idell Creek LN
Hannibal, MO 63401-6458

Mailing address

9126 Idell Creek LN
Hannibal, MO 63401-6458
Phone (217) 231-1179

Other providers in Hannibal, MO

All providers in Hannibal, MO · Dental Hygienist in Missouri

Sources for this page

Verify at the official NPI Registry.