Provider Demographics
NPI:1669229209
Name:SKP DDS PA
Entity type:Organization
Organization Name:SKP DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRUNAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-450-8358
Mailing Address - Street 1:32303 MAHOGANY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4127
Mailing Address - Country:US
Mailing Address - Phone:516-450-8358
Mailing Address - Fax:
Practice Address - Street 1:38034 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1383
Practice Address - Country:US
Practice Address - Phone:516-450-8358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty