Provider Demographics
NPI:1558936575
Name:DHILLON DENTAL GROUP, PA
Entity Type:Organization
Organization Name:DHILLON DENTAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:UPINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-805-1152
Mailing Address - Street 1:200 E JIMMIE LEEDS RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9567
Mailing Address - Country:US
Mailing Address - Phone:609-652-0888
Mailing Address - Fax:609-652-0400
Practice Address - Street 1:200 E JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9567
Practice Address - Country:US
Practice Address - Phone:609-652-0888
Practice Address - Fax:609-652-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty