Provider Demographics
NPI:1265864227
Name:S KAUR DDS INC.
Entity Type:Organization
Organization Name:S KAUR DDS INC.
Other - Org Name:SIERRA TAHOE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKHJEET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-603-9071
Mailing Address - Street 1:3443 LAKE TAHOE BLVD
Mailing Address - Street 2:SUITE # B
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-8910
Mailing Address - Country:US
Mailing Address - Phone:530-544-3426
Mailing Address - Fax:
Practice Address - Street 1:3443 LAKE TAHOE BLVD
Practice Address - Street 2:SUITE # B
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-8910
Practice Address - Country:US
Practice Address - Phone:530-544-3426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60389122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty