Provider Demographics
NPI:1053300533
Name:KABRA, HARIRAM R (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARIRAM
Middle Name:R
Last Name:KABRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 PONDVIEW RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033
Mailing Address - Country:US
Mailing Address - Phone:518-477-7537
Mailing Address - Fax:518-477-6757
Practice Address - Street 1:2500 PONDVIEW RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033
Practice Address - Country:US
Practice Address - Phone:518-477-7537
Practice Address - Fax:518-477-6757
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034677-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice