Individual provider · NPI-1

Hetal P Desai

Dentist, General Practice · Muskogee, OK

NPI number1770868978
StatusActive
Last updated in NPPESJan 16, 2014

Details

NPI
1770868978
Entity type
Individual (NPI-1)
Name
Hetal P Desai
Sex
Female
Sole proprietor
No
Enumeration date
Oct 19, 2011
Last updated
Jan 16, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice6417OKYes
122300000X Dentist27496TX

Practice location

930a W Shawnee St
Muskogee, OK 74401-3511

Phone 918-682-2819

Mailing address

930a W Shawnee St
Muskogee, OK 74401-3511

Phone 918-682-2819

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