Organization
CHETAN SHIVARAM DDS P.C
Active
Other names
DONIPHAN FAMILY DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN SHIVARAM DDS (OWNER/PRESIDENT)
(915) 877-4949
Entity
Organization
Contact information
Practice address
6821 DONIPHAN DR, CANUTILLO, TX 79835
(915) 788-4949
(915) 877-4242
Mailing address
6821 DONIPHAN DRIVE, CANUTILLO, TX 79835
(915) 788-4949
(915) 877-4242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21666
TX
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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