Provider Demographics
NPI:1013457118
Name:KAUR AND BORRERO DDS DENTAL CORP
Entity Type:Organization
Organization Name:KAUR AND BORRERO DDS DENTAL CORP
Other - Org Name:SPLASH KIDS DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARMJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-284-5080
Mailing Address - Street 1:1801 TULLY RD # SUITEA1
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2931
Mailing Address - Country:US
Mailing Address - Phone:209-284-5080
Mailing Address - Fax:209-438-4434
Practice Address - Street 1:1801 TULLY RD STE A1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2937
Practice Address - Country:US
Practice Address - Phone:209-284-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59660122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty