Provider Demographics
NPI:1689154692
Name:MAHAVIR PADMAVATI CORP
Entity Type:Organization
Organization Name:MAHAVIR PADMAVATI CORP
Other - Org Name:SOMERSET STREET FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KALUSKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-412-0891
Mailing Address - Street 1:42 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4828
Mailing Address - Country:US
Mailing Address - Phone:908-412-0891
Mailing Address - Fax:908-412-0986
Practice Address - Street 1:42 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4828
Practice Address - Country:US
Practice Address - Phone:908-412-0891
Practice Address - Fax:908-412-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-19
Last Update Date:2018-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty