Provider Demographics
NPI:1801395041
Name:BHARDWAJ, PREETI (DMD)
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:BHARDWAJ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 2730
Mailing Address - Street 2:
Mailing Address - City:DRUMHELLER
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T0J0Y0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:394 1ST STREET EAST
Practice Address - Street 2:
Practice Address - City:DRUMHELLER
Practice Address - State:ALBERTA
Practice Address - Zip Code:T0Y0J0
Practice Address - Country:CA
Practice Address - Phone:403-823-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN218201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice