Provider Demographics
NPI:1255475976
Name:PAREKH, GEETANJALI P (BDS, MDS)
Entity Type:Individual
Prefix:DR
First Name:GEETANJALI
Middle Name:P
Last Name:PAREKH
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E BURGESS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6388
Mailing Address - Country:US
Mailing Address - Phone:850-474-8816
Mailing Address - Fax:850-474-1735
Practice Address - Street 1:611 E BURGESS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6388
Practice Address - Country:US
Practice Address - Phone:850-474-8816
Practice Address - Fax:850-474-1735
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN108151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice