MEDICARE: DR. GITA YITTA D.M.D

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
1	1223G0001X	General Practice Dentistry	D10060	OR

General Provider Information

NPI Number	:	1235573940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GITA YITTA D.M.D

Provider Business Mailing Address
First Line	:	1142 N HASKELL ST
Second Line	:
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-2496
Country	:	US
Telephone Number	:	917-645-2901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1035 NE 6TH ST STE B
Second Line	:	BRIGHT NOW DENTAL
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1298
Country	:	US
Telephone Number	:	541-479-6696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2013
Last Update Date	:	05/25/2016

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