Provider Demographics
NPI:1013299189
Name:BHATTI, GURVINDER SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:GURVINDER
Middle Name:SINGH
Last Name:BHATTI
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 1:730 VILLAGIO PL
Mailing Address - Street 2:428
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4285
Mailing Address - Country:US
Mailing Address - Phone:559-907-1194
Mailing Address - Fax:
Practice Address - Street 1:320 NORTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2424
Practice Address - Country:US
Practice Address - Phone:252-991-6843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX274051223G0001X
NC9631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice