Provider Demographics
NPI:1225697345
Name:SAYBALL, MOLLY ANNE (DMD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANNE
Last Name:SAYBALL
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:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:NH
Mailing Address - Zip Code:03608-0970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 MEADOW ACCESS LN
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:NH
Practice Address - Zip Code:03608-4416
Practice Address - Country:US
Practice Address - Phone:603-756-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist