Provider Demographics
NPI:1508224205
Name:AMANI S TAKHER DMD INC
Entity Type:Organization
Organization Name:AMANI S TAKHER DMD INC
Other - Org Name:PENA ADOBE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-448-6456
Mailing Address - Street 1:161 BUTCHER RD STE A
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5685
Mailing Address - Country:US
Mailing Address - Phone:707-448-6456
Mailing Address - Fax:
Practice Address - Street 1:161 BUTCHER RD STE A
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-5685
Practice Address - Country:US
Practice Address - Phone:707-448-6456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61488305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization