Provider Demographics
NPI:1083012520
Name:DHALIWAL, SATVIR K (DDS)
Entity Type:Individual
Prefix:DR
First Name:SATVIR
Middle Name:K
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21646 N LOWER SACRAMENTO RD
Mailing Address - Street 2:
Mailing Address - City:ACAMPO
Mailing Address - State:CA
Mailing Address - Zip Code:95220-9435
Mailing Address - Country:US
Mailing Address - Phone:209-368-5712
Mailing Address - Fax:
Practice Address - Street 1:21646 N LOWER SACRAMENTO RD
Practice Address - Street 2:
Practice Address - City:ACAMPO
Practice Address - State:CA
Practice Address - Zip Code:95220-9435
Practice Address - Country:US
Practice Address - Phone:209-368-5712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA642581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice