Provider Demographics
NPI:1548588551
Name:BAGGA, PREETMOHINDER SINGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:PREETMOHINDER
Middle Name:SINGH
Last Name:BAGGA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 ROUTE 10 E
Mailing Address - Street 2:SUITE #3
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2132
Mailing Address - Country:US
Mailing Address - Phone:973-537-7500
Mailing Address - Fax:973-537-7400
Practice Address - Street 1:447 ROUTE 10 E
Practice Address - Street 2:SUITE #3
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2132
Practice Address - Country:US
Practice Address - Phone:973-537-7500
Practice Address - Fax:973-537-7400
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI018985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist