MEDICARE: DR. AVANTIKA NATH BDS

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
1	1223G0001X	General Practice Dentistry	48836	CA

General Provider Information

NPI Number	:	1386694693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVANTIKA NATH BDS

Provider Business Mailing Address
First Line	:	1380 HOWARD ST
Second Line	:	ROOM 508
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2638
Country	:	US
Telephone Number	:	415-255-3516
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 HOWARD ST
Second Line	:	ROOM 508
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2638
Country	:	US
Telephone Number	:	415-255-3516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	08/11/2012

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