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General NPI Number Information
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NPI Number | 1962688903
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Entity Type | Organization
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Legal Business Name | VIHAR BHAKTA DENTAL CORPORATION
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Dates
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Enumeration Date | 01/20/2008
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Last Update Date | 01/20/2008
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Provider Practice Location Address
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Address Line | 10907 ATLANTIC AVE
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City | LYNWOOD
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State | CA
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Zip | 90262-2310
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Country | US
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Telephone | 310-886-0606
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Fax | 310-886-0505
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Provider Business Mailing Address
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Address Line | 10907 ATLANTIC AVE
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City | LYNWOOD
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State | CA
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Zip | 90262-2310
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Country | US
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Telephone |
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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. VIHAR P BHAKTA
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Credential | DMD
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Telephone | 310-988-6373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 55426
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License Number State | CA
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