Organization
TINA GUPTA DDS PA II
Active
Other names
Smile Studio of Henderson
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TINA GUPTA DDS (DENTIST)
(252) 572-2520
Entity
Organization
Contact information
Practice address
451 RUIN CREEK RD, SUITE 201, HENDERSON, NC 27536-2878
(252) 572-2520
(252) 572-2527
Mailing address
451 RUIN CREEK RD, SUITE 201, HENDERSON, NC 27536-2878
(252) 572-2520
(252) 572-2527
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914161
—
NC
Enumeration date
10/21/2010
Last updated
10/21/2010
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