Provider Demographics
NPI:1871265504
Name:SHARMA, GAURAV
Entity Type:Individual
Prefix:DR
First Name:GAURAV
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WORTHEN RD UNIT A3
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4831
Mailing Address - Country:US
Mailing Address - Phone:857-333-5150
Mailing Address - Fax:
Practice Address - Street 1:274 DANIEL WEBSTER HWY UNIT 6
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5729
Practice Address - Country:US
Practice Address - Phone:603-880-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04697122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist