Provider Demographics
NPI:1073713392
Name:PRAGNESH J DHOLAKIYA AND POORAN B DALWANI
Entity Type:Organization
Organization Name:PRAGNESH J DHOLAKIYA AND POORAN B DALWANI
Other - Org Name:DUARTE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAGNESH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DHOLAKIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-357-2254
Mailing Address - Street 1:1217 BUENA VISTA ST
Mailing Address - Street 2:STE 202
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2408
Mailing Address - Country:US
Mailing Address - Phone:626-357-2254
Mailing Address - Fax:626-358-0305
Practice Address - Street 1:1217 BUENA VISTA ST
Practice Address - Street 2:STE 202
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2408
Practice Address - Country:US
Practice Address - Phone:626-357-2254
Practice Address - Fax:626-358-0305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRAGNESH J DHOLAKIYA AND POORAN B DALWANI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty