Provider Demographics
NPI:1700013281
Name:NANVA, HARJAP S (DDS)
Entity Type:Individual
Prefix:
First Name:HARJAP
Middle Name:S
Last Name:NANVA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 E US HIGHWAY 83
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9409
Mailing Address - Country:US
Mailing Address - Phone:956-263-1222
Mailing Address - Fax:
Practice Address - Street 1:5326 E US HIGHWAY 83
Practice Address - Street 2:SUITE A-3
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9409
Practice Address - Country:US
Practice Address - Phone:956-263-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice