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General NPI Number Information
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NPI Number | 1407268394
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Entity Type | Individual
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Provider Name | PRASHANSA SHARMA-MAKWANA D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 07/19/2017
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Provider Practice Location Address
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Address Line | 5929 W PEORIA AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-1207
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Country | US
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Telephone | 623-432-3386
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Fax |
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Provider Business Mailing Address
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Address Line | 8444 E INDIAN SCHOOL RD APT B2056
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3079
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D009536
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License Number State | AZ
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