Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS040891 | PA |
NPI | 1003377722 |
---|---|
Provider Name | Dr. Amrita Bhan |
First Address | Lititz, PA 17543-8048 |
Second Address | Lancaster, PA 17601-6463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2019 |
Last Update Date | 26/03/2019 |