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NPI Code Detail

MEDICARE: DR. PRATHVI POOJARY D.D.S.

MEDICARE: DR. PRATHVI POOJARY D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry28870TX
21223G0001XGeneral Practice Dentistry2901020516MI

General Provider Information

NPI Number : 1134400781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRATHVI POOJARY D.D.S.
Provider Business Mailing Address
First Line : 19451 W WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48228-3361
Country : US
Telephone Number : 313-271-1800
Fax Number : 313-945-1810
Provider Business Practice Location Address
First Line : 19451 W WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48228-3361
Country : US
Telephone Number : 313-271-1800
Fax Number : 313-945-1810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 04/29/2024

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Directions to “ DR. PRATHVI POOJARY D.D.S.” Practice Location

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