Provider Demographics
NPI:1548590193
Name:KAUR, MEENAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEENAL
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CORBETT DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-1500
Mailing Address - Country:US
Mailing Address - Phone:781-267-1361
Mailing Address - Fax:360-851-2926
Practice Address - Street 1:30 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-7102
Practice Address - Country:US
Practice Address - Phone:781-391-2440
Practice Address - Fax:781-391-9620
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice