Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DS040041 | PA |
NPI | 1003220740 |
---|---|
Provider Name | Bhadresh Makani |
First Address | Huntingdon Valley, PA 19006-6957 |
Second Address | Chester Springs, PA 19425-9564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 22/07/2016 |