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General NPI Number Information
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NPI Number | 1275728651
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Entity Type | Individual
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Provider Name | POOJA MEHROTRA DDS
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 8285 W UNION HILLS DR SUITE 103
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City | GLENDALE
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State | AZ
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Zip | 85308-0510
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Country | US
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Telephone | 646-527-5611
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Fax |
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Provider Business Mailing Address
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Address Line | 8285 W UNION HILLS DR SUITE 103
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City | GLENDALE
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State | AZ
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Zip | 85308-0510
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Country | US
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Telephone | 646-527-5611
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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 | DN008573
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License Number State | AZ
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