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NPI Code Detail

MEDICARE: PREETI PEWEKAR DDS

MEDICARE:   PREETI  PEWEKAR  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist49637CA

General Provider Information

NPI Number : 1053356402
Entity Type Code : Individual
Provider Name (Legal Business Name) : PREETI PEWEKAR DDS
Provider Business Mailing Address
First Line : 555 W BENJAMIN HOLT DR
Second Line : BUILDING B
City : STOCKTON
State : CA
Zip : 95207-3839
Country : US
Telephone Number : 209-476-4700
Fax Number : 209-478-6890
Provider Business Practice Location Address
First Line : 1639 HOLLENBECK AVE
Second Line :
City : SUNNYVALE
State : CA
Zip : 94087-5402
Country : US
Telephone Number : 408-732-6931
Fax Number : 408-731-8660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/08/2007

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Directions to “ PREETI PEWEKAR DDS” Practice Location

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