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General NPI Number Information
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NPI Number | 1790819076
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Entity Type | Organization
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Legal Business Name | DR. BHAVIN. S GANDHI DDS INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 11347 183 RD STREET
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 562-403-0430
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Fax | 562-403-0432
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Provider Business Mailing Address
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Address Line | 11347 183 RD STREET
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 562-403-0430
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Fax | 562-403-0432
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BHAVIN S GANDHI
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Credential | DDS
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Telephone | 562-403-0430
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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 | 37419
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License Number State | CA
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