Provider Demographics
NPI:1952827032
Name:SANDHU, KAMAL PREET KAUR (DDS)
Entity Type:Individual
Prefix:
First Name:KAMAL PREET
Middle Name:KAUR
Last Name:SANDHU
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 1:401 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4592
Mailing Address - Country:US
Mailing Address - Phone:937-216-7162
Mailing Address - Fax:
Practice Address - Street 1:1255 W SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-3938
Practice Address - Country:US
Practice Address - Phone:559-490-1326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-20
Last Update Date:2017-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1019391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice