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General NPI Number Information
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NPI Number | 1861721367
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Entity Type | Individual
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Provider Name | DIPTI U MANIAR DDS
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Gender | Female
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 141 PIKE ST
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City | PORT JERVIS
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State | NY
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Zip | 12771-1807
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Country | US
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Telephone | 845-856-4002
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Fax | 845-858-1127
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Provider Business Mailing Address
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Address Line | 141 PIKE ST
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City | PORT JERVIS
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State | NY
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Zip | 12771-1807
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Country | US
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Telephone | 845-856-4002
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Fax | 845-858-1127
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 040482
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License Number State | NY
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