MEDICARE: HARJAP S NANVA 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
1	1223G0001X	General Practice Dentistry	24586	TX

General Provider Information

NPI Number	:	1700013281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARJAP S NANVA DDS

Provider Business Mailing Address
First Line	:	5326 E US HIGHWAY 83
Second Line	:	SUITE A-3
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-9409
Country	:	US
Telephone Number	:	956-263-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	5326 E US HIGHWAY 83
Second Line	:	SUITE A-3
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-9409
Country	:	US
Telephone Number	:	956-263-1222
Fax Number	:

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

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	08/05/2010

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