Provider Demographics
NPI:1639492424
Name:NAVJOT S. KHURANA, DMD, PLLC
Entity Type:Organization
Organization Name:NAVJOT S. KHURANA, DMD, PLLC
Other - Org Name:BROADMOOR FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:509-547-0571
Mailing Address - Street 1:5701 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8214
Mailing Address - Country:US
Mailing Address - Phone:509-547-0571
Mailing Address - Fax:509-547-0572
Practice Address - Street 1:5701 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8214
Practice Address - Country:US
Practice Address - Phone:509-547-0571
Practice Address - Fax:509-547-0572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009717261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental