Individual
DR. BHUSHAN THAKKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS, MDS
Contact information
Practice address
1851 MACGREGOR DOWNS RD, GREENVILLE, NC 27834-5925
(252) 737-7044
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/06/2016
Last updated
09/30/2020
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