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General NPI Number Information
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NPI Number | 1639800360
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Entity Type | Individual
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Provider Name | AASTHA GANDHI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 3550 HARDEN BLVD UNIT 101
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City | LAKELAND
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State | FL
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Zip | 33803-5940
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Country | US
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Telephone | 863-226-4424
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Fax |
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Provider Business Mailing Address
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Address Line | 915 N FRANKLIN ST UNIT 1705
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City | TAMPA
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State | FL
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Zip | 33602-3799
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Country | US
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Telephone | 850-226-1041
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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 | DN27382
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License Number State | FL
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