Basic Information
| Provider Information | |||||||||
| NPI: | 1275835803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANA | ||||||||
| FirstName: | KRUNAL | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | D.D.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 77 PENNINGTON AVE | ||||||||
| Address2: | APT C8 | ||||||||
| City: | PASSAIC | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070554841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8625716883 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1070 SAINT JAMES AVE | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011041453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137375665 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2010 | ||||||||
| LastUpdateDate: | 12/02/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DN1855597 | MA | Y | Dental Providers | Dentist | General Practice |
No ID Information.