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General NPI Number Information
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NPI Number | 1801248950
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Entity Type | Organization
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Legal Business Name | BABAN DHARIWAL DDS PA INC
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 5280 DOUGLAS BLVD STE 100
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City | GRANITE BAY
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State | CA
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Zip | 95746-6205
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Country | US
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Telephone | 916-800-5001
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Fax | 916-791-1659
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Provider Business Mailing Address
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Address Line | 6049 DOUGLAS BLVD STE 9
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City | ROSEVILLE
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State | CA
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Zip | 95746-6249
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Country | US
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Telephone | 916-791-4133
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BABAN DHARIWAL
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Credential | DDS
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Telephone | 916-298-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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