Provider Demographics
NPI:1457500043
Name:CAPITOL FAMILY DENTAL
Entity Type:Organization
Organization Name:CAPITOL FAMILY DENTAL
Other - Org Name:P.S.SIDHU & ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARAMJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-461-4140
Mailing Address - Street 1:8422 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1825
Mailing Address - Country:US
Mailing Address - Phone:414-461-4140
Mailing Address - Fax:414-461-5033
Practice Address - Street 1:8422 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1825
Practice Address - Country:US
Practice Address - Phone:414-461-4140
Practice Address - Fax:414-461-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty