Individual
ADITI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 RIVER NORTH BLVD, STEPHENVILLE, TX 76401-1804
(254) 865-2810
Mailing address
1100 W REYNOSA AVE, DE LEON, TX 76444-1630
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29291
TX
Other
Enumeration date
07/10/2013
Last updated
06/19/2014
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