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General NPI Number Information
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NPI Number | 1336370840
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Entity Type | Organization
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Legal Business Name | KANG AND BHAKTA DENTAL CORP
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 1053 N STATE COLLEGE BLVD
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City | ANAHEIM
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State | CA
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Zip | 92806-2702
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Country | US
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Telephone | 714-687-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 1053 N STATE COLLEGE BLVD
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City | ANAHEIM
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State | CA
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Zip | 92806-2702
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Country | US
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Telephone | 714-687-0800
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. VIHAR BHAKTA
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Credential | DMD
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Telephone | 310-988-6373
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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 | 55426
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License Number State | CA
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