Provider Demographics
NPI:1134399876
Name:CHATTHA, MONPREET KAUR (DDS)
Entity type:Individual
Prefix:
First Name:MONPREET
Middle Name:KAUR
Last Name:CHATTHA
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 1:3150 RUBINO DR
Mailing Address - Street 2:APT. 201
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-6385
Mailing Address - Country:US
Mailing Address - Phone:408-386-5708
Mailing Address - Fax:
Practice Address - Street 1:3150 RUBINO DR
Practice Address - Street 2:APT. 201
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-6385
Practice Address - Country:US
Practice Address - Phone:408-386-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2009-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist