Provider Demographics
NPI:1225770779
Name:GAINESVILLE DENTAL ARTS, PLLC
Entity Type:Organization
Organization Name:GAINESVILLE DENTAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PALWINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:703-380-1246
Mailing Address - Street 1:7949 HERITAGE VILLAGE PLAZA
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155
Mailing Address - Country:US
Mailing Address - Phone:703-743-2324
Mailing Address - Fax:844-725-5287
Practice Address - Street 1:7949 HERITAGE VILLAGE, PLAZA GAINESVILLE DENTAL ARTS
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-743-2324
Practice Address - Fax:844-725-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty