Individual
JAI-INDER GHOTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4500 8TH DIVISION RD, COLUMBIA, SC 29207-5700
(803) 751-2618
Mailing address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14037860-9926
UT
Other
Enumeration date
06/05/2023
Last updated
08/02/2024
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