Individual
DR. POOJA ANJU AGNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
113 W INDEPENDENCE ST, SHAMOKIN, PA 17872-5315
(570) 644-3900
(570) 644-3901
Mailing address
113 W INDEPENDENCE ST, SHAMOKIN, PA 17872-5315
(570) 644-3900
(570) 644-3901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS028254L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680508925
EMPLOYER TAX ID#
—
Enumeration date
09/21/2006
Last updated
11/12/2020
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