Provider Demographics
NPI:1164546172
Name:NARULA, MOHENDER (DMD)
Entity Type:Individual
Prefix:
First Name:MOHENDER
Middle Name:
Last Name:NARULA
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 1:70679 BOOTHILL RD
Mailing Address - Street 2:72-027 HIGHWAY 111, STE C.
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3405
Mailing Address - Country:US
Mailing Address - Phone:760-328-4000
Mailing Address - Fax:
Practice Address - Street 1:72027 HIGHWAY 111 STE C
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4927
Practice Address - Country:US
Practice Address - Phone:760-340-5155
Practice Address - Fax:760-340-1607
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice