Individual
GAURAV DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
710 FRANKLIN ST STE 200, MICHIGAN CITY, IN 46360-3564
(219) 872-6200
Mailing address
710 FRANKLIN ST STE 200, MICHIGAN CITY, IN 46360-3564
(219) 872-6200
(219) 879-2915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032448
IL
122300000X
Dentist
Primary
12013104A
IN
122300000X
Dentist
DN22075
FL
Other
Enumeration date
07/20/2016
Last updated
01/25/2021
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