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General NPI Number Information
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NPI Number | 1124351150
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Entity Type | Organization
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Legal Business Name | DENESH K KHULLAR DDS PA
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 2524 CRESTWOOD RD STE 2
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7648
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Country | US
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Telephone | 501-753-7366
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 241763
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0014
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENESH KHULLAR
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Credential | D.D.S.
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Telephone | 501-753-7366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3448
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License Number State | AR
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