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General NPI Number Information
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NPI Number | 1336752948
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Entity Type | Individual
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Provider Name | SAAVAN BHAKTA DMD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 14021 N 51ST AVE STE 116
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City | GLENDALE
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State | AZ
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Zip | 85306-4840
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Country | US
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Telephone | 602-529-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 17551 BRIARWOOD ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4401
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Country | US
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Telephone | 714-717-1006
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | D011980
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License Number State | AZ
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