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General NPI Number Information
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NPI Number | 1285862854
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Entity Type | Individual
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Provider Name | HETAL MAHENDRA NATHA
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 8608 PRESTON RD SUITE 112
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City | PLANO
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State | TX
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Zip | 75024-3316
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Country | US
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Telephone | 888-749-3297
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 E ABRAM ST
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City | ARLINGTON
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State | TX
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Zip | 76010-1437
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Country | US
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Telephone | 512-789-7564
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 15593
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License Number State | TX
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