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Individual

ABHISHEK BHAUMIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2244 S BUCKNER BLVD STE B, DALLAS, TX 75227-8603
(214) 381-0663
Mailing address
2244 S BUCKNER BLVD STE B, DALLAS, TX 75227-8603

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22114561
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
390200000X
TX
Enumeration date
02/18/2013
Last updated
11/27/2015
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