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General NPI Number Information
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NPI Number | 1801781109
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Entity Type | Individual
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Provider Name | MAITRY SONAGRA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2120 RAILROAD AVE STE 105
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City | PITTSBURG
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State | CA
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Zip | 94565-4880
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Country | US
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Telephone | 717-982-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 ST PATRICK WAY APT 568
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City | DUBLIN
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State | CA
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Zip | 94568-4887
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Country | US
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Telephone | 717-982-9680
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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 | 111572
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License Number State | CA
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