MEDICARE: DR. POOJA M SANTWANI 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	122300000X	Dentist	54333	CA

General Provider Information

NPI Number	:	1619151248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. POOJA M SANTWANI D.D.S

Provider Business Mailing Address
First Line	:	2272 MISSION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-1812
Country	:	US
Telephone Number	:	415-863-2980
Fax Number	:

Provider Business Practice Location Address
First Line	:	2272 MISSION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-1812
Country	:	US
Telephone Number	:	415-863-2980
Fax Number	:

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

Provider Enumeration Date	:	12/18/2007
Last Update Date	:	07/11/2012

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