Provider Demographics
NPI:1245457944
Name:KOHLI, MEETU RALLI (DMD)
Entity type:Individual
Prefix:DR
First Name:MEETU
Middle Name:RALLI
Last Name:KOHLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:2808 NIGHTHAWK CIR
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1888
Mailing Address - Country:US
Mailing Address - Phone:215-813-2686
Mailing Address - Fax:610-676-9030
Practice Address - Street 1:450 CRESSON BLVD,
Practice Address - Street 2:SUITE 303
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456-1218
Practice Address - Country:US
Practice Address - Phone:610-676-9030
Practice Address - Fax:610-676-9032
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS0355291223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics