Organization
1706 SAPANA KOTHARY DDS INC
Active
Other names
Willow Glen Dental Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
SOFIA M ZAMORANO (OFFICE MANAGER)
(408) 504-4935
Entity
Organization
Contact information
Practice address
1706 WILLOW ST STE A, SAN JOSE, CA 95125-5216
(408) 478-9081
Mailing address
1706 WILLOW ST STE A, SAN JOSE, CA 95125-5216
(408) 478-9081
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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