Provider Demographics
NPI:1871219188
Name:GAWAND, SAYALI (DMD)
Entity type:Individual
Prefix:DR
First Name:SAYALI
Middle Name:
Last Name:GAWAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-2430
Mailing Address - Country:US
Mailing Address - Phone:818-406-6944
Mailing Address - Fax:
Practice Address - Street 1:73 MAIN ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-2416
Practice Address - Country:US
Practice Address - Phone:603-752-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty