Provider Demographics
NPI:1265883342
Name:MOTWANI, RAJEEV KUMAR (DMD MS)
Entity type:Individual
Prefix:
First Name:RAJEEV
Middle Name:KUMAR
Last Name:MOTWANI
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD # D7-6
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0416
Mailing Address - Country:US
Mailing Address - Phone:352-273-6750
Mailing Address - Fax:352-392-7609
Practice Address - Street 1:1600 SW ARCHER RD # D7-6
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0416
Practice Address - Country:US
Practice Address - Phone:352-273-6750
Practice Address - Fax:352-392-7609
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP16101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery