Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D10835 | MN |
NPI | 1003918038 |
---|---|
Provider Name | Dr. Pravin Aturaliya |
First Address | Duluth, MN 55802 |
Second Address | Duluth, MN 55802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 18/07/2016 |