Provider Demographics
NPI:1578719423
Name:DHAM, UTTMA (DMD)
Entity Type:Individual
Prefix:DR
First Name:UTTMA
Middle Name:
Last Name:DHAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:UTTMA
Other - Middle Name:
Other - Last Name:SACHDEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:51 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7007
Mailing Address - Country:US
Mailing Address - Phone:954-476-4535
Mailing Address - Fax:954-476-7684
Practice Address - Street 1:51 NW 100TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7007
Practice Address - Country:US
Practice Address - Phone:954-476-4535
Practice Address - Fax:954-476-7684
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN163141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice