Healthcare Provider Details

I. General information

NPI: 1134540271
Provider Name (Legal Business Name): SARAH NUNES RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 NEW BEDFORD RD
ROCHESTER MA
02770-4125
US

IV. Provider business mailing address

PO BOX 22
ROCHESTER MA
02770-0022
US

V. Phone/Fax

Practice location:
  • Phone: 774-202-5519
  • Fax:
Mailing address:
  • Phone: 774-202-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH132642
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: