Provider Demographics
NPI:1346672821
Name:DHALIWAL, AVNEET (DDS)
Entity Type:Individual
Prefix:DR
First Name:AVNEET
Middle Name:
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 N LILLEY RD
Mailing Address - Street 2:SUNRISE FAMILY DENTAL CARE
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3685
Mailing Address - Country:US
Mailing Address - Phone:734-981-4909
Mailing Address - Fax:
Practice Address - Street 1:5730 N LILLEY RD
Practice Address - Street 2:SUNRISE FAMILY DENTAL CARE
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3685
Practice Address - Country:US
Practice Address - Phone:734-981-4909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist