| Prem K Kathuria Pa | |
|
1670 S Hwy 17 92 Longwood FL 32750-6516 | |
| (407) 339-4700 | |
| (407) 339-7736 |
| Full Name | Prem K Kathuria Pa |
|---|---|
| Speciality | Dentist |
| Location | 1670 S Hwy 17 92, Longwood, Florida |
| Authorized Official Name and Position | Prem K Kathuria (DENTIST) |
| Authorized Official Contact | 4073394700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prem K Kathuria Pa 1670 S Hwy 17 92 Longwood FL 32750-6516 Ph: (407) 339-4700 | Prem K Kathuria Pa 1670 S Hwy 17 92 Longwood FL 32750-6516 Ph: (407) 339-4700 |
| NPI Number | 1922449214 |
|---|---|
| Provider Enumeration Date | 07/15/2013 |
| Last Update Date | 07/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922449214 | NPI | - | NPPES |
| 074725400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN8196 (Florida) | Primary |
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