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NPI Code Detail

MEDICARE: MRS. SHWETA GAUTAM DAFTARY D.D.S

MEDICARE:  MRS. SHWETA GAUTAM DAFTARY  D.D.S
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
11223G0001XGeneral Practice Dentistry17275TX

General Provider Information

NPI Number : 1942219480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHWETA GAUTAM DAFTARY D.D.S
Provider Business Mailing Address
First Line : 18020 CREEK VISTA CT
Second Line :
City : DALLAS
State : TX
Zip : 75252-5622
Country : US
Telephone Number : 972-818-8600
Fax Number : 214-853-4266
Provider Business Practice Location Address
First Line : 6009 BELT LINE RD STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75254-7890
Country : US
Telephone Number : 972-239-1998
Fax Number : 972-239-8899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 02/01/2022

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Directions to “ MRS. SHWETA GAUTAM DAFTARY D.D.S” Practice Location

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