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General NPI Number Information
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NPI Number | 1376941013
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Entity Type | Organization
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Legal Business Name | K&H DENTAL PA
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 1808 CHICO HIGHWAY
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City | BRIDGEPORT
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State | TX
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Zip | 76426
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Country | US
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Telephone | 940-683-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 1808 CHICO HIGHWAY
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City | BRIDGEPORT
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State | TX
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Zip | 76426
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Country | US
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Telephone | 940-683-3233
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUMEET SINGH MALHOTRA
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Credential |
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Telephone | 617-412-0792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 26104
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26104
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License Number State | TX
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