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Individual

DR. ISHWARANAND G BHAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
300 S STATE RD, MARYSVILLE, PA 17053-1221
(717) 957-3711
(717) 957-4583
Mailing address
300 S STATE RD, MARYSVILLE, PA 17053-1221
(717) 957-3711
(717) 957-4583

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS020219-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005161980001
PA
Enumeration date
01/23/2007
Last updated
07/08/2007
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