Provider Demographics
NPI:1992711709
Name:RITA BHAT DMD PA
Entity type:Organization
Organization Name:RITA BHAT DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-799-0377
Mailing Address - Street 1:134 PROFESSIONAL PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:704-799-0377
Mailing Address - Fax:704-799-0378
Practice Address - Street 1:134 PROFESSIONAL PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117
Practice Address - Country:US
Practice Address - Phone:704-799-0377
Practice Address - Fax:704-799-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6122122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty