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General NPI Number Information
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NPI Number | 1487204350
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Entity Type | Organization
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Legal Business Name | UTTMA S DHAM , DMD PA
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 51 NW 100TH AVE
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City | PLANTATION
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State | FL
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Zip | 33324-7007
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Country | US
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Telephone | 954-476-4535
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Fax | 954-476-7684
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Provider Business Mailing Address
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Address Line | 51 NW 100TH AVE
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City | PLANTATION
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State | FL
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Zip | 33324-7007
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Country | US
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Telephone | 954-476-4535
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Fax | 954-476-7684
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Authorized Official
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Title or Position | DENTIST - OWNER
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Name | DR. UTTMA S DHAM
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Credential | DMD
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Telephone | 954-476-4535
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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 |
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License Number State |
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