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General NPI Number Information
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NPI Number | 1558749663
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Entity Type | Organization
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Legal Business Name | SHARMA ACCESS DENTAL PS
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 1412 NE 134TH ST #140
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City | VANCOUVER
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State | WA
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Zip | 98685-2719
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Country | US
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Telephone | 360-573-4848
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Fax | 360-573-6272
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Provider Business Mailing Address
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Address Line | 1412 NE 134TH ST #140
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City | VANCOUVER
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State | WA
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Zip | 98685-2719
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Country | US
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Telephone | 360-573-4848
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Fax | 360-573-6272
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANJEEV K SHARMA
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Credential | BDS MDS MS
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Telephone | 360-921-6856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 8301
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License Number State | WA
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