Provider Demographics
NPI:1356514442
Name:PJ SINGH DENTAL CORP
Entity type:Organization
Organization Name:PJ SINGH DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARAMJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-221-6666
Mailing Address - Street 1:4598 S TRACY BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8107
Mailing Address - Country:US
Mailing Address - Phone:209-221-6666
Mailing Address - Fax:209-221-7002
Practice Address - Street 1:4598 S TRACY BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-8107
Practice Address - Country:US
Practice Address - Phone:209-221-6666
Practice Address - Fax:209-221-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty