Provider Demographics
NPI:1497208961
Name:VIRWANI, SONAL
Entity Type:Individual
Prefix:DR
First Name:SONAL
Middle Name:
Last Name:VIRWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 UNION ST
Mailing Address - Street 2:DR.DENTAL OF LYNN
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1348
Mailing Address - Country:US
Mailing Address - Phone:781-691-3010
Mailing Address - Fax:781-691-3033
Practice Address - Street 1:270 UNION ST
Practice Address - Street 2:DR.DENTAL OF LYNN
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1348
Practice Address - Country:US
Practice Address - Phone:781-691-3010
Practice Address - Fax:781-691-3033
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist