Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN08076 | FL |
NPI | 1598882813 |
---|---|
Provider Name | Dr. Perminder Wadhwa |
First Address | Fort Lauderdale, FL 33315-2643 |
Second Address | Fort Lauderdale, FL 33315-2643 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 09/07/2007 |