Basic Information
| Provider Information | |||||||||
| NPI: | 1841638962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NANDA | ||||||||
| FirstName: | NANDITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 W 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | STILLWATER | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740744017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057076135 | ||||||||
| FaxNumber: | 4057070602 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 S JACKSON RD | ||||||||
| Address2: | UNIT 12 | ||||||||
| City: | PHARR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785776859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566830386 | ||||||||
| FaxNumber: | 9566830506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2013 | ||||||||
| LastUpdateDate: | 12/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 29023 | TX | Y | Dental Providers | Dentist |
No ID Information.