Provider Demographics
NPI:1164315412
Name:SKINNER, SARAH (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SKINNER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 SERENITY LN NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-6603
Mailing Address - Country:US
Mailing Address - Phone:507-993-5448
Mailing Address - Fax:
Practice Address - Street 1:607 1ST DR NW
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-3072
Practice Address - Country:US
Practice Address - Phone:507-437-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist