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General NPI Number Information
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NPI Number | 1669779468
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Entity Type | Organization
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Legal Business Name | NIKHITA SHREE KUMAR INC.
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 811 S BABCOCK ST
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City | MELBOURNE
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State | FL
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Zip | 32901-1890
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Country | US
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Telephone | 321-729-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 811 S BABCOCK ST
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City | MELBOURNE
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State | FL
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Zip | 32901-1890
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Country | US
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Telephone | 321-729-0022
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SADESH KUMAR
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Credential | D.M.D
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Telephone | 321-729-0022
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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 | DN17073
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License Number State | FL
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