Provider Demographics
NPI:1902923279
Name:DATWANI, SEEMA V (DDS)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:V
Last Name:DATWANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1336
Mailing Address - Country:US
Mailing Address - Phone:732-388-5400
Mailing Address - Fax:732-388-3663
Practice Address - Street 1:1093 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1336
Practice Address - Country:US
Practice Address - Phone:732-388-5400
Practice Address - Fax:732-388-3663
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02230100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist