Provider Demographics
NPI:1851315741
Name:SUFI, GURMINDERAJIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GURMINDERAJIT
Middle Name:
Last Name:SUFI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 MAYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1500
Mailing Address - Country:US
Mailing Address - Phone:916-928-1608
Mailing Address - Fax:
Practice Address - Street 1:3710 STATE HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-4021
Practice Address - Country:US
Practice Address - Phone:530-458-5501
Practice Address - Fax:530-458-8660
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist