Provider Demographics
NPI:1700272960
Name:PRANATI G TATI, DMD,PC
Entity type:Organization
Organization Name:PRANATI G TATI, DMD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANATI
Authorized Official - Middle Name:G
Authorized Official - Last Name:TATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-395-3247
Mailing Address - Street 1:820 BELVEDERE ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:820 BELVEDERE ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4018
Practice Address - Country:US
Practice Address - Phone:717-243-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0372411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty