Organization
SPA DENTAL GROUP INC.
Active
Parent organization
SPA DENTAL GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPA DENTAL GROUP, INC.
Authorized official
SHEBANI PAHWA DDS (CEO)
(301) 910-3100
Entity
Organization
Contact information
Practice address
111 E 57TH ST # 204, NEW YORK, NY 10022-2009
(202) 431-6957
Mailing address
111 E 57TH ST STE 204, NEW YORK, NY 10022-2009
(917) 858-7155
(732) 631-8525
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
12/15/2021
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