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General NPI Number Information
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NPI Number | 1003342007
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Entity Type | Organization
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Legal Business Name | BRINDHA SUBRAMANIAN, BDS MS DENTAL CORPORATION
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 991 SARATOGA AVE STE 220
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City | SAN JOSE
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State | CA
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Zip | 95129-2357
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Country | US
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Telephone | 408-692-5437
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Fax | 408-498-7737
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Provider Business Mailing Address
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Address Line | 991 SARATOGA AVE STE 220
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City | SAN JOSE
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State | CA
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Zip | 95129-2357
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Country | US
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Telephone | 408-692-5437
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Fax | 408-498-7737
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. BRINDHA SUBRAMANIAN
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Credential | BDS, MS
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Telephone | 504-952-6169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 58339
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License Number State | CA
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