Provider Demographics
NPI:1619436367
Name:PRANATI G TATI DMDII,PC
Entity Type:Organization
Organization Name:PRANATI G TATI DMDII,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANATI
Authorized Official - Middle Name:G
Authorized Official - Last Name:TATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-763-1676
Mailing Address - Street 1:163 WARM SUNDAY WAY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3801
Mailing Address - Country:US
Mailing Address - Phone:717-395-3247
Mailing Address - Fax:
Practice Address - Street 1:1509 CEDAR CLIFF DR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-7720
Practice Address - Country:US
Practice Address - Phone:717-763-1676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental