Provider Demographics
NPI:1346216223
Name:GUNE, ABHIJIT PRAKASH (DDS)
Entity Type:Individual
Prefix:MR
First Name:ABHIJIT
Middle Name:PRAKASH
Last Name:GUNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19969 GREENLEY RD STE D
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5908
Mailing Address - Country:US
Mailing Address - Phone:209-532-0034
Mailing Address - Fax:209-532-0036
Practice Address - Street 1:19969 GREENLEY RD STE D
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5908
Practice Address - Country:US
Practice Address - Phone:209-532-0034
Practice Address - Fax:209-532-0036
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice