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General NPI Number Information
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NPI Number | 1912357690
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Entity Type | Individual
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Provider Name | BARSHA MOKTAN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 357 S GULPH ROAD #110
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406
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Country | US
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Telephone | 610-337-2325
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 PIMLICO DR
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City | EAST NORRITON
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State | PA
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Zip | 19403-3962
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Country | US
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Telephone | 484-636-4153
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS040853
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License Number State | PA
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