Provider Demographics
NPI:1285850875
Name:KHETARPAL, ALPANA HANDA (BDS,DDS)
Entity type:Individual
Prefix:DR
First Name:ALPANA
Middle Name:HANDA
Last Name:KHETARPAL
Suffix:
Gender:F
Credentials:BDS,DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4176 HOLIDAY ST NW STE 4
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2532
Mailing Address - Country:US
Mailing Address - Phone:330-493-1004
Mailing Address - Fax:330-649-9756
Practice Address - Street 1:4176 HOLIDAY ST NW STE 4
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2532
Practice Address - Country:US
Practice Address - Phone:330-493-1004
Practice Address - Fax:330-649-9756
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0160954Medicaid