Provider Demographics
NPI:1205230661
Name:MATHUR, ADITI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADITI
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 E.FLORENCE AVE,
Mailing Address - Street 2:SUITE #G
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201
Mailing Address - Country:US
Mailing Address - Phone:562-927-2377
Mailing Address - Fax:562-927-6008
Practice Address - Street 1:6320 E.FLORENCE AVE,
Practice Address - Street 2:SUITE G
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201
Practice Address - Country:US
Practice Address - Phone:562-927-2377
Practice Address - Fax:562-927-6008
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 63497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist