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General NPI Number Information
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NPI Number | 1518759695
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Entity Type | Organization
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Legal Business Name | SOTA FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 307 MAIN ST N
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City | STEWARTVILLE
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State | MN
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Zip | 55976-1234
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Country | US
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Telephone | 507-533-4492
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Fax | 507-533-4101
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Provider Business Mailing Address
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Address Line | 307 MAIN ST N PO BOX 65
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City | STEWARTVILLE
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State | MN
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Zip | 55976
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Country | US
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Telephone | 507-533-4492
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Fax | 507-533-4101
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Authorized Official
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Title or Position | OWNER
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Name | DR. ABHEER N JAYAKAR
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Credential | DDS
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Telephone | 507-533-4492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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