Sarah Elizabeth Boo, DDS
Individual provider Active NPI Dentist · White Bear Lake, MN
NPI 1821148347 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821148347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D10365 (MN)
- Practice address
- 4717 Highway 61 N
White Bear Lake, MN 55110-3227 - Phone
- (651) 426-2116
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10365 | MN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D10365 | MN | Yes |
Addresses
Primary practice location
4717 Highway 61 N
White Bear Lake, MN 55110-3227
Mailing address
4717 Highway 61 N
White Bear Lake, MN 55110-3227
Phone (651) 426-2116
Other names
- Sarah Boo
Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.