Individual
SHIVANI GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4855 E WARNER RD UNIT B9, PHOENIX, AZ 85044-3308
(480) 424-4890
Mailing address
4483 S WILDFLOWER PL, CHANDLER, AZ 85248-4860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011835
AZ
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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