Provider Demographics
NPI:1477602829
Name:VIRK, SUKHPAL K (DDS)
Entity Type:Individual
Prefix:
First Name:SUKHPAL
Middle Name:K
Last Name:VIRK
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 1:4007 N MARKS AVE SUITE #102
Mailing Address - Street 2:ASHLAND DENTAL CENTER
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722
Mailing Address - Country:US
Mailing Address - Phone:559-225-5800
Mailing Address - Fax:559-225-4004
Practice Address - Street 1:4007 N MARKS AVE SUITE #102
Practice Address - Street 2:ASHLAND DENTAL CENTER
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722
Practice Address - Country:US
Practice Address - Phone:559-225-5800
Practice Address - Fax:559-225-4004
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45338122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist