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General NPI Number Information
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NPI Number | 1205145521
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Entity Type | Individual
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Provider Name | VANI BHATNAGAR PRABAKARAN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 34 BARKLEY CIR
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City | FORT MYERS
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State | FL
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Zip | 33907-7530
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Country | US
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Telephone | 239-275-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 295 3RD ST
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7324
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Country | US
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Telephone | 646-673-3752
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN20723
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License Number State | FL
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