Provider Demographics
NPI:1518445469
Name:JASWAL, KAMALPREET (DDS)
Entity Type:Individual
Prefix:
First Name:KAMALPREET
Middle Name:
Last Name:JASWAL
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 1:3307 EVERGREEN WAY STE 706
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-2065
Mailing Address - Country:US
Mailing Address - Phone:360-335-8899
Mailing Address - Fax:360-335-1219
Practice Address - Street 1:3307 EVERGREEN WAY STE 706
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-2065
Practice Address - Country:US
Practice Address - Phone:360-335-8899
Practice Address - Fax:360-335-1219
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE608617761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice