Provider Demographics
NPI:1184153132
Name:GUHA, UPOMA (BDS, MS)
Entity type:Individual
Prefix:DR
First Name:UPOMA
Middle Name:
Last Name:GUHA
Suffix:
Gender:F
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 CENTER DRIVE, ROOM # D9-16C
Mailing Address - Street 2:UNIVERSITY OF FLORIDA, COLLEGE OF DENTISTRY
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0415
Mailing Address - Country:US
Mailing Address - Phone:352-273-5843
Mailing Address - Fax:
Practice Address - Street 1:1395 CENTER DRIVE, ROOM # D1-11
Practice Address - Street 2:UNIVERSITY OF FLORIDA, COLLEGE OF DENTISTRY
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0415
Practice Address - Country:US
Practice Address - Phone:352-273-7954
Practice Address - Fax:716-829-2440
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP680122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist