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General NPI Number Information
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NPI Number | 1346629052
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Entity Type | Individual
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Provider Name | KRISTIE LYNN PARTIN-AGARWAL DMD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 165TH MEDICAL GROUP 358 OELSCHIG DR
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City | SAVANNAH
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State | GA
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Zip | 31408
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Country | US
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Telephone | 912-966-8201
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Fax |
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Provider Business Mailing Address
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Address Line | 10632 GRETNA GREEN DR
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City | TAMPA
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State | FL
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Zip | 33626-1832
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Country | US
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Telephone | 360-292-5887
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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 | 9379316-9922
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License Number State | UT
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