Provider Demographics
NPI:1720539521
Name:GAWRYCH, BARBARA (RDH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:GAWRYCH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 LOWER LN
Mailing Address - Street 2:
Mailing Address - City:LEVANT
Mailing Address - State:ME
Mailing Address - Zip Code:04456-4384
Mailing Address - Country:US
Mailing Address - Phone:207-745-2548
Mailing Address - Fax:
Practice Address - Street 1:27 LOWER LN
Practice Address - Street 2:
Practice Address - City:LEVANT
Practice Address - State:ME
Practice Address - Zip Code:04456-4384
Practice Address - Country:US
Practice Address - Phone:207-745-2548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3058124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist