Provider Demographics
NPI:1790185213
Name:KAUR, HARSIMRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARSIMRAN
Middle Name:
Last Name:KAUR
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 1:14529 N CREEK DR
Mailing Address - Street 2:APT B208
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5469
Mailing Address - Country:US
Mailing Address - Phone:770-549-9426
Mailing Address - Fax:
Practice Address - Street 1:3943 116TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-8448
Practice Address - Country:US
Practice Address - Phone:360-226-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60491841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist