Organization Name: | MUKTAJEEVAN DENTAL ARTS, LLC |
NPI Number: | 1124380167 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SNEHAL PATEL (OWNER/DENTIST) |
Mailing Address: | 104 Hickory Corner Rd Ste 202 East Windsor |
State: | NJ US |
Postal Code: | 085202460 |
Phone Number: | 6093367735 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2012 |
NPI Last Update Date: | 06/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 22DI02305200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |