Individual
POOLAK BHATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DMD
Contact information
Practice address
1890 N BROAD ST STE 100, FUQUAY VARINA, NC 27526-3657
(919) 586-8565
Mailing address
1 GUTHRIE SQ DEPT OF, SAYRE, PA 18840-1625
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
10659
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
MD481288
PA
Other
Enumeration date
04/17/2017
Last updated
05/23/2025
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