Provider Demographics
NPI:1598015711
Name:DOGRA, SHRUTEE
Entity Type:Individual
Prefix:DR
First Name:SHRUTEE
Middle Name:
Last Name:DOGRA
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 1:8 LOCKSLEY AVE APT 8H
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3850
Mailing Address - Country:US
Mailing Address - Phone:408-828-7529
Mailing Address - Fax:
Practice Address - Street 1:8 LOCKSLEY AVE APT 8H
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3850
Practice Address - Country:US
Practice Address - Phone:408-828-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA617221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice