Provider Demographics
NPI:1497806723
Name:DHILLON, NIMRAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIMRAT
Middle Name:
Last Name:DHILLON
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 1:45728 LARCHMONT DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4717
Mailing Address - Country:US
Mailing Address - Phone:734-254-0185
Mailing Address - Fax:734-946-4808
Practice Address - Street 1:25721 GODDARD RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3974
Practice Address - Country:US
Practice Address - Phone:734-946-7700
Practice Address - Fax:734-946-4808
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI167941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice