Individual
DEVNA UMAKANT PANDIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2990 W GRANT LINE RD, TRACY, CA 95304-7901
(209) 830-7797
Mailing address
3191 HUTTON PL, TRACY, CA 95377-6689
(860) 992-7031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
57585
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002093475
—
CT
Enumeration date
06/23/2005
Last updated
06/26/2012
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