Provider Demographics
NPI:1265567531
Name:RAKHRA, SATBIR SINGH (BDS)
Entity type:Individual
Prefix:
First Name:SATBIR
Middle Name:SINGH
Last Name:RAKHRA
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:SATBIR
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:532 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2458
Mailing Address - Country:US
Mailing Address - Phone:413-693-1045
Mailing Address - Fax:
Practice Address - Street 1:1145 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103
Practice Address - Country:US
Practice Address - Phone:413-693-1045
Practice Address - Fax:413-737-3608
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA90681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice