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General NPI Number Information
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NPI Number | 1760899066
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Entity Type | Individual
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Provider Name | DHAVALKUMAR RANA
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Gender | Male
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 225 EXCHANGE ST SUITE D
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City | BURLESON
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State | TX
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Zip | 76028-4588
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Country | US
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Telephone | 817-426-9337
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Fax |
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Provider Business Mailing Address
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Address Line | 419 OLD ELKHART RD.
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City | PALESTINE
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State | TX
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Zip | 75801
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Country | US
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Telephone |
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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 | 30184
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License Number State | TX
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