Basic Information
| Provider Information | |||||||||
| NPI: | 1437660149 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAHYOUNI | ||||||||
| FirstName: | DATTY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | X | ||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3053 | ||||||||
| Address2: | |||||||||
| City: | PITTSFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012023053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134496935 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 343 MAIN ST REAR | ||||||||
| Address2: | |||||||||
| City: | GREAT BARRINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012301846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135285565 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2017 | ||||||||
| LastUpdateDate: | 01/03/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DL13527 | MA | N | Dental Providers | Dentist | 1223G0001X | DL13527 | MA | Y | Dental Providers | Dentist | General Practice |
No ID Information.