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General NPI Number Information
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NPI Number | 1407396062
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Entity Type | Organization
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Legal Business Name | BHATIA DENTAL CORPORATION
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 6721 N MILBURN AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93722-2140
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Country | US
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Telephone | 559-825-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 10898 N JOHN ALBERT AVE
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City | FRESNO
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State | CA
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Zip | 93730-5302
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Country | US
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Telephone | 415-518-7862
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MITIN BHATIA
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Credential | DDS
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Telephone | 415-518-7862
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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 | 58882
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License Number State | CA
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