Provider Demographics
NPI:1013184365
Name:AMANDEEP BRAR VIRK D.D.S.INC
Entity Type:Organization
Organization Name:AMANDEEP BRAR VIRK D.D.S.INC
Other - Org Name:BV FAMILY &COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDEEP
Authorized Official - Middle Name:BRAR
Authorized Official - Last Name:VIRK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-489-5000
Mailing Address - Street 1:2 UNION SQ
Mailing Address - Street 2:SUITE#230
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-4495
Mailing Address - Country:US
Mailing Address - Phone:510-489-5000
Mailing Address - Fax:510-489-5002
Practice Address - Street 1:2 UNION SQ
Practice Address - Street 2:SUITE#230
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-4495
Practice Address - Country:US
Practice Address - Phone:510-489-5000
Practice Address - Fax:510-489-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty