Healthcare Provider Details

I. General information

NPI: 1427806652
Provider Name (Legal Business Name): AEK HARI GEETA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/13/2024
Certification Date: 05/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 ROUTE 100
BARTO PA
19504-8724
US

IV. Provider business mailing address

107 WESTMINSTER DR
NORTH WALES PA
19454-1218
US

V. Phone/Fax

Practice location:
  • Phone: 267-500-1504
  • Fax:
Mailing address:
  • Phone: 267-500-1504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: MRS. GITABEN K DUDHAT
Title or Position: OWNER
Credential:
Phone: 267-500-1504