Healthcare Provider Details

I. General information

NPI: 1689838591
Provider Name (Legal Business Name): SARA JANEL GOTWALT D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S 7TH ST
AKRON PA
17501-1333
US

IV. Provider business mailing address

112 S 7TH ST
AKRON PA
17501-1333
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-6980
  • Fax:
Mailing address:
  • Phone: 717-627-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS037596
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: