MEDICARE: DR. ROHIT K DAVE 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
1	1223G0001X	General Practice Dentistry	019.028345	IL

General Provider Information

NPI Number	:	1457666430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROHIT K DAVE D.D.S.

Provider Business Mailing Address
First Line	:	111 FREMONT LN
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-9821
Country	:	US
Telephone Number	:	815-579-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	METC/C, ATTN: MS. ANDERSON
Second Line	:	3176 CPL JOHNSON ROAD
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-1247
Country	:	US
Telephone Number	:	210-808-2194
Fax Number	:

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

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	08/09/2024

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