Provider Demographics
NPI:1497487219
Name:SOHI, HARLEEN KAUR
Entity Type:Individual
Prefix:
First Name:HARLEEN KAUR
Middle Name:
Last Name:SOHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 SUFFIELD ST APT 24
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1739
Mailing Address - Country:US
Mailing Address - Phone:716-471-9004
Mailing Address - Fax:
Practice Address - Street 1:950 STATE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3145
Practice Address - Country:US
Practice Address - Phone:413-264-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist