Provider Demographics
NPI:1114433646
Name:MILAN KHAKHRIA DMD MS PA
Entity Type:Organization
Organization Name:MILAN KHAKHRIA DMD MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAKHRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-452-9988
Mailing Address - Street 1:104 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7008
Mailing Address - Country:US
Mailing Address - Phone:954-452-9988
Mailing Address - Fax:954-452-9966
Practice Address - Street 1:104 NW 100TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7008
Practice Address - Country:US
Practice Address - Phone:954-452-9988
Practice Address - Fax:954-452-9966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental