Provider Demographics
NPI:1003079229
Name:SINGH, MANJEET KAUR
Entity Type:Individual
Prefix:DR
First Name:MANJEET
Middle Name:KAUR
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 N DRUID HILLS RD NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3919
Mailing Address - Country:US
Mailing Address - Phone:404-633-4030
Mailing Address - Fax:404-633-1687
Practice Address - Street 1:2910 N DRUID HILLS RD NE
Practice Address - Street 2:SUITE B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3919
Practice Address - Country:US
Practice Address - Phone:404-633-4030
Practice Address - Fax:404-633-1687
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN009397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist