Provider Demographics
NPI:1194340620
Name:JAMBARD, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:JAMBARD
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 1:5 HALON TER
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3207
Mailing Address - Country:US
Mailing Address - Phone:860-906-8333
Mailing Address - Fax:
Practice Address - Street 1:5 HALON TER
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3207
Practice Address - Country:US
Practice Address - Phone:860-906-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist