Individual
BHAVANA N THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
281 E HAMILTON AVE, SUITE 3, CAMPBELL, CA 95008
(408) 871-0877
(408) 871-2807
Mailing address
281 E HAMILTON AVE, SUITE 3, CAMPBELL, CA 95008-0232
(408) 871-0877
(408) 871-2807
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CA45033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9824101
MEDICAL
CA
Enumeration date
04/20/2006
Last updated
11/16/2015
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