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General NPI Number Information
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NPI Number | 1417219015
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Entity Type | Individual
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Provider Name | ANKUSH JINDAL D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 237 HILDRED DR
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City | BURLINGTON
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State | VT
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Zip | 05401-3694
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Country | US
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Telephone | 607-331-2718
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Fax |
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Provider Business Mailing Address
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Address Line | 237 HILDRED DR
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City | BURLINGTON
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State | VT
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Zip | 05401-3694
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Country | US
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Telephone | 607-331-2718
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 016.0088973
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License Number State | VT
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