Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 56746 | CA |
NPI | 1043420821 |
---|---|
Provider Name | Dr. Suruchi Laxman Warwatkar |
First Address | Santa Clara, CA 95051-4640 |
Second Address | Milpitas, CA 95035-5412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 17/03/2018 |