Provider Demographics
NPI:1104206739
Name:SUMEET SINGH, DDS, A DENTAL CORPORATION
Entity Type:Organization
Organization Name:SUMEET SINGH, DDS, A DENTAL CORPORATION
Other - Org Name:CENTRAL COAST DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-917-2526
Mailing Address - Street 1:1130 FREMONT BLVD
Mailing Address - Street 2:SUITE-106
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-5700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 FREMONT BLVD
Practice Address - Street 2:SUITE-106
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-5700
Practice Address - Country:US
Practice Address - Phone:831-917-2526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA625141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty