Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 21456 | TX |
NPI | 1063636074 |
---|---|
Provider Name | Dr. Joshika Kanabar |
First Address | Dallas, TX 75231-5056 |
Second Address | Dallas, TX 75231-5056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 16/01/2018 |