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General NPI Number Information
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NPI Number | 1407911183
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Entity Type | Organization
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Legal Business Name | SURESH VAKHARIA DENTIST PC
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Dates
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Enumeration Date | 12/24/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 3474 BROADWAY, GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10031
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Country | US
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Telephone | 212-926-5692
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Fax |
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Provider Business Mailing Address
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Address Line | 3474 BROADWAY, GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10031
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Country | US
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Telephone | 212-926-5692
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURESH V VAKHARIA
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Credential | BDS,MDS,DDS
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Telephone | 212-926-5692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 034568
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License Number State | NY
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