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General NPI Number Information
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NPI Number | 1639805781
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Entity Type | Individual
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Provider Name | KALIN JEETESH BHAVAN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 2515 E ELLIOTT ST
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City | WICHITA FALLS
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State | TX
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Zip | 76308-3708
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Country | US
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Telephone | 940-696-9702
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Fax | 940-691-8425
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Provider Business Mailing Address
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Address Line | 2529 CIMA HILL DR
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City | PLANO
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State | TX
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Zip | 75025-4765
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Country | US
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Telephone | 214-562-7068
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38789
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License Number State | TX
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