| NPI | 1720196173 |
|---|---|
| Former Name | PAVITHRA G SHETTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51522) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 51522) |
| 1223G0001X Dentist, General Practice (Licence: NY 0518561) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2020-03-03 |