Individual
JAGRUTI BHAKTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
639 W 173RD ST APT 1A, NEW YORK, NY 10032-1426
(212) 928-4480
Mailing address
700 1ST ST APT 16PB, HOBOKEN, NJ 07030-8802
(646) 785-9137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
051844-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02837956
—
NY
Enumeration date
01/29/2007
Last updated
07/08/2007
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