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General NPI Number Information
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NPI Number | 1720768740
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Entity Type | Organization
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Legal Business Name | ONE MOBILE DENTAL
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 7300 SANDLAKE COMMONS BLVD STE 317
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City | ORLANDO
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State | FL
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Zip | 32819-8011
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Country | US
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Telephone | 925-362-1800
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Fax | 925-855-1160
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Provider Business Mailing Address
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Address Line | 103 SYCAMORE VALLEY RD W
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City | DANVILLE
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State | CA
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Zip | 94526-3957
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Country | US
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Telephone | 925-362-1800
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Fax | 925-855-1160
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. SUDHA S CHINTA
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Credential | DDS, MSD
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Telephone | 510-329-5731
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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 |
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License Number State |
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