Provider Demographics
NPI:1770595795
Name:MALHOTRA, SACHIN O (DMD)
Entity type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:O
Last Name:MALHOTRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WHITTIER HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MOULTONBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03254-3684
Mailing Address - Country:US
Mailing Address - Phone:603-253-4363
Mailing Address - Fax:603-253-4148
Practice Address - Street 1:60 WHITTIER HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:MOULTONBORO
Practice Address - State:NH
Practice Address - Zip Code:03254-3684
Practice Address - Country:US
Practice Address - Phone:603-253-4363
Practice Address - Fax:603-253-4148
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30303303Medicaid