Provider Demographics
NPI:1073091617
Name:SANGHERA, HARSIMRAN SINGH (DMD)
Entity Type:Individual
Prefix:
First Name:HARSIMRAN
Middle Name:SINGH
Last Name:SANGHERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E TUOLUMNE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1544
Mailing Address - Country:US
Mailing Address - Phone:209-277-6115
Mailing Address - Fax:
Practice Address - Street 1:981 E TUOLUMNE RD STE 110
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1544
Practice Address - Country:US
Practice Address - Phone:209-667-5405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE3757913OtherSTATE ID