Provider Demographics
NPI:1083927214
Name:SINGH, KANWARPAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:KANWARPAL
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 MIDDLE TPKE W
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-3833
Mailing Address - Country:US
Mailing Address - Phone:860-661-4000
Mailing Address - Fax:860-661-4002
Practice Address - Street 1:419 MIDDLE TPKE W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3833
Practice Address - Country:US
Practice Address - Phone:860-661-4000
Practice Address - Fax:860-661-4002
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010315122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist