Sukkawala, Ketan Arun

Sukkawala, Ketan Arun is an individual health care provider with primary practice located at 1103 Rock Prairie Rd Ste 1001 , College Station TX 77845-8344. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Sukkawala, Ketan Arun can be contacted via phone (979) 694-5200.

Contact Information

Primary practice address
1103 Rock Prairie Rd Ste 1001 College Station TX 77845-8344
Phone: (979) 694-5200
Fax: (979) 694-5223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 19635 Texas

Profile Details

NPI number 1710030077
LBN Legal business name Sukkawala, Ketan Arun
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Nov 16th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710030077 NPPES
Texas Other 19635 DENTAL LICENSE
Texas MEDICAID 009547301 DENTAL LICENSE

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