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General NPI Number Information
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NPI Number | 1659543312
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Entity Type | Organization
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Legal Business Name | P.C.DUTTA,M.D.,P.A.
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 275 W CAMPBELL RD
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City | RICHARDSON
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State | TX
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Zip | 75080-3601
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Country | US
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Telephone | 972-238-9065
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Fax |
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Provider Business Mailing Address
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Address Line | 275 W CAMPBELL RD
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City | RICHARDSON
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State | TX
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Zip | 75080-3601
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Country | US
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Telephone | 972-238-9065
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PARITOSH CHANDRA DUTTA
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Credential | M.D.
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Telephone | 972-238-9065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | E 7900
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License Number State | TX
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