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General NPI Number Information
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NPI Number | 1417116633
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Entity Type | Organization
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Legal Business Name | ASHOO KHANUJA DDS MD INC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 6701 ROCKSIDE RD SUITE #209
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2358
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Country | US
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Telephone | 216-328-1234
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Fax | 216-328-1229
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Provider Business Mailing Address
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Address Line | 6701 ROCKSIDE RD SUITE #209
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2358
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Country | US
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Telephone | 216-328-1234
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Fax | 216-328-1229
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Authorized Official
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Title or Position | OWNER
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Name | AHSOO KHANUJA
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Credential | DDS MD
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Telephone | 216-328-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 21566
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License Number State | OH
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