Individual
DEEPAK GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
93 AIRPORT RD, HAZLETON, PA 18202-9366
(570) 453-0555
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS037606
PA
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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