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General NPI Number Information
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NPI Number | 1154632354
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Entity Type | Individual
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Provider Name | KAUSHAL PRAVIN KAPADIA DMD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 06/09/2012
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Provider Practice Location Address
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Address Line | 712 WYNCROFT TER APT 4
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City | LANCASTER
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State | PA
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Zip | 17603-6968
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Country | US
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Telephone | 443-481-7743
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Fax |
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Provider Business Mailing Address
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Address Line | 712 WYNCROFT TER APT 4
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City | LANCASTER
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State | PA
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Zip | 17603-6968
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Country | US
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Telephone | 443-481-7743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14528
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS038321
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License Number State | PA
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