Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 08930 | IA |
NPI | 1770838880 |
---|---|
Provider Name | Dr. Chandni Desai |
First Address | Iowa City, IA 52242-1001 |
Second Address | Iowa City, IA 52242-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 09/05/2019 |