Individual
SANJAY BHATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
883 NE MAIN ST, SIMPSONVILLE, SC 29681-2051
(864) 756-1060
Mailing address
883 NE MAIN ST, SIMPSONVILLE, SC 29681-2051
(864) 756-1060
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10265
SC
390200000X
Student in an Organized Health Care Education/Training Program
ETN338
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ETN338
TEXAS STATE BOARD OF DENTAL EXAMINERS
TX
Enumeration date
07/28/2015
Last updated
11/07/2022
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