Provider Demographics
NPI:1730836859
Name:KOTHARY DENTAL CORPORATION
Entity type:Organization
Organization Name:KOTHARY DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:ZAMORANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-504-4935
Mailing Address - Street 1:15075 LOS GATOS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2049
Mailing Address - Country:US
Mailing Address - Phone:408-356-2059
Mailing Address - Fax:408-252-1904
Practice Address - Street 1:15075 LOS GATOS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2049
Practice Address - Country:US
Practice Address - Phone:408-356-2059
Practice Address - Fax:408-252-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty