Provider Demographics
NPI:1851927487
Name:SORABH DAS DDS INC
Entity Type:Organization
Organization Name:SORABH DAS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SORABH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:707-782-8667
Mailing Address - Street 1:690 E TABOR AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4079
Mailing Address - Country:US
Mailing Address - Phone:707-427-3100
Mailing Address - Fax:
Practice Address - Street 1:690 E TABOR AVE STE C
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4079
Practice Address - Country:US
Practice Address - Phone:707-427-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty