Provider Demographics
NPI:1396385902
Name:ARORA, KHUSHBOO
Entity Type:Individual
Prefix:DR
First Name:KHUSHBOO
Middle Name:
Last Name:ARORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 MOON LAKE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-1598
Mailing Address - Country:US
Mailing Address - Phone:612-308-7997
Mailing Address - Fax:
Practice Address - Street 1:1501 W STOUT ST
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-5001
Practice Address - Country:US
Practice Address - Phone:715-236-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14683122300000X
WI1002311-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist