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General NPI Number Information
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NPI Number | 1871994830
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Entity Type | Organization
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Legal Business Name | GAURANG AMIN, A DENTAL CORPORATION
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 2230 SUNSET BLVD STE 370
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City | ROCKLIN
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State | CA
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Zip | 95765-4274
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Country | US
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Telephone | 916-791-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 1760 AVONDALE DR
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City | ROSEVILLE
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State | CA
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Zip | 95747-8389
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Country | US
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Telephone | 951-965-6666
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GAURANG AMIN
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Credential | DDS
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Telephone | 951-965-6666
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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 | 54122
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License Number State | CA
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