Provider Demographics
NPI:1790145134
Name:DHILLON DENTAL CORP
Entity Type:Organization
Organization Name:DHILLON DENTAL CORP
Other - Org Name:SMILERITE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAPNEET
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-556-2967
Mailing Address - Street 1:121 N I ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-4408
Mailing Address - Country:US
Mailing Address - Phone:559-673-3581
Mailing Address - Fax:
Practice Address - Street 1:121 N I ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-4408
Practice Address - Country:US
Practice Address - Phone:559-673-3581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-27
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty