Provider Demographics
NPI:1851029839
Name:SHANDIN HILLS KARIA DENTAL CORPORATION
Entity Type:Organization
Organization Name:SHANDIN HILLS KARIA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-477-1349
Mailing Address - Street 1:1357 KENDALL DR STE 10
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-4118
Mailing Address - Country:US
Mailing Address - Phone:909-473-1788
Mailing Address - Fax:909-473-1022
Practice Address - Street 1:1357 KENDALL DR STE 10
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-4118
Practice Address - Country:US
Practice Address - Phone:909-473-1788
Practice Address - Fax:909-473-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental