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Individual
POONAM VALLABHBHAI
Active
Individual
POONAM VALLABHBHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0025849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25849
TX STATE BOARD OF DENTAL EXAMINERS - DDS LICENSE
TX
Enumeration date
08/26/2010
Last updated
12/11/2014
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