Provider Demographics
NPI:1689684797
Name:BATH, SUNEET SINGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUNEET
Middle Name:SINGH
Last Name:BATH
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 1:4538 MARTIN WAY E
Mailing Address - Street 2:#103
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516
Mailing Address - Country:US
Mailing Address - Phone:360-493-1866
Mailing Address - Fax:360-493-1445
Practice Address - Street 1:4538 MARTIN WAY E
Practice Address - Street 2:E103
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516
Practice Address - Country:US
Practice Address - Phone:360-493-1866
Practice Address - Fax:360-493-1445
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009299122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist