Provider Demographics
NPI:1366652331
Name:PUNJABI, BINDOO ANIL (DDS)
Entity Type:Individual
Prefix:
First Name:BINDOO
Middle Name:ANIL
Last Name:PUNJABI
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 1:627 GOLDEN WEST DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6415
Mailing Address - Country:US
Mailing Address - Phone:909-798-9958
Mailing Address - Fax:909-335-0477
Practice Address - Street 1:1180 NEVADA ST
Practice Address - Street 2:STE#100
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2894
Practice Address - Country:US
Practice Address - Phone:909-335-0474
Practice Address - Fax:909-335-0477
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist