Individual
BANDANA BISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4520 LAMAR AVE, PARIS, TX 75462-5119
(903) 737-8543
Mailing address
543 BROOKES WAY, RENO, TX 75462-6025
(646) 645-0761
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30180
TX
122300000X
Dentist
DS035779
PA
Other
Enumeration date
09/20/2006
Last updated
01/15/2015
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