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General NPI Number Information
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NPI Number | 1518121433
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Entity Type | Organization
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Legal Business Name | THELMA C DAWANA DMD A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 995 MONTAGUE EXPRESSWAY SUITE112
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City | MILPITAS
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State | CA
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Zip | 95035
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Country | US
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Telephone | 408-719-1005
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Fax | 408-907-9182
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Provider Business Mailing Address
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Address Line | 995 MONTAGUE EXPRESSWAY SUITE112
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City | MILPITAS
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State | CA
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Zip | 95035
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Country | US
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Telephone | 408-719-1005
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Fax | 408-907-9182
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. THELMA C DAWANA
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Credential |
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Telephone | 408-719-1005
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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 | 54746
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License Number State | CA
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