Provider Demographics
NPI:1952491011
Name:BRAR, AMANBIR (DDS)
Entity Type:Individual
Prefix:
First Name:AMANBIR
Middle Name:
Last Name:BRAR
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 1:4438 MENLO AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4433
Mailing Address - Country:US
Mailing Address - Phone:619-757-9926
Mailing Address - Fax:
Practice Address - Street 1:2745 W SHAW AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3315
Practice Address - Country:US
Practice Address - Phone:559-227-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist