Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 24157 | TX |
NPI | 1053567800 |
---|---|
Provider Name | Dr. Richa Dutta |
First Address | White Hall, MD 21161-9104 |
Second Address | The Colony, TX 75056-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2008 |
Last Update Date | 07/01/2020 |