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General NPI Number Information
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NPI Number | 1629695150
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Entity Type | Individual
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Provider Name | VISHAL BHAMBRI
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Gender | Male
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 130 MILL ST
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City | BRISTOL
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State | PA
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Zip | 19007-4807
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Country | US
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Telephone | 215-788-3009
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Fax |
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Provider Business Mailing Address
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Address Line | 11 LISA CT
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City | COLONIA
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State | NJ
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Zip | 07067-2214
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Country | US
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Telephone | 917-873-3832
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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 | DS042770
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License Number State | PA
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