Provider Demographics
NPI:1265417422
Name:SINGH, PARMINDERPAL (DMD)
Entity type:Individual
Prefix:DR
First Name:PARMINDERPAL
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FAIRBANKS ST
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-1561
Mailing Address - Country:US
Mailing Address - Phone:906-779-5246
Mailing Address - Fax:
Practice Address - Street 1:16088 N BALSAM LN
Practice Address - Street 2:
Practice Address - City:SPALDING
Practice Address - State:MI
Practice Address - Zip Code:49886
Practice Address - Country:US
Practice Address - Phone:906-497-5205
Practice Address - Fax:906-497-4033
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010175601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3525181Medicaid
WI33787000Medicaid