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General NPI Number Information
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NPI Number | 1740833805
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Entity Type | Organization
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Legal Business Name | SUCHETA AMANJEE DDS INC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 520 COTTONWOOD ST STE 3
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City | WOODLAND
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State | CA
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Zip | 95695-3603
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Country | US
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Telephone | 530-662-7558
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Fax | 530-668-2121
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Provider Business Mailing Address
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Address Line | 520 COTTONWOOD ST STE 3
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City | WOODLAND
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State | CA
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Zip | 95695-3603
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Country | US
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Telephone | 530-662-7558
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Fax | 530-668-2121
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Authorized Official
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Title or Position | OWNER CEO
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Name | SUCHETA SARATHY AMANJEE
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Credential | DDS
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Telephone | 916-780-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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