Healthcare Provider Details
I. General information
NPI: 1396469334
Provider Name (Legal Business Name): BHAVENDRASINH SAYANIA DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1102 E FRANKLIN ST
MONROE NC
28112-5028
US
IV. Provider business mailing address
1102 E FRANKLIN ST
MONROE NC
28112-5028
US
V. Phone/Fax
- Phone: 704-289-9473
- Fax: 704-283-9185
- Phone: 704-289-9473
- Fax: 704-283-9185
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRYSTAL
ROLLINGS
Title or Position: OFFICE MANAGER
Credential:
Phone: 704-289-9473