Provider Demographics
NPI:1710127931
Name:SOHI-THADWAL, ANUREET (DDS)
Entity Type:Individual
Prefix:
First Name:ANUREET
Middle Name:
Last Name:SOHI-THADWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 N EL DORADO ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4467
Mailing Address - Country:US
Mailing Address - Phone:209-373-0051
Mailing Address - Fax:
Practice Address - Street 1:5904 N EL DORADO ST
Practice Address - Street 2:SUITE C
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4467
Practice Address - Country:US
Practice Address - Phone:209-373-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice