Provider Demographics
NPI:1316550098
Name:MANEET DHARIA DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:MANEET DHARIA DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANEET
Authorized Official - Middle Name:M
Authorized Official - Last Name:DHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-438-0175
Mailing Address - Street 1:6990 EL CAMINO REAL STE O
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4112
Mailing Address - Country:US
Mailing Address - Phone:760-438-0175
Mailing Address - Fax:760-438-4490
Practice Address - Street 1:6990 EL CAMINO REAL STE O
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4112
Practice Address - Country:US
Practice Address - Phone:760-438-0175
Practice Address - Fax:760-438-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101969OtherDENTIST