Provider Demographics
NPI:1457720674
Name:SANDHU, GURBAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:GURBAZ
Middle Name:
Last Name:SANDHU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 WEBB CHAPEL RD # 121
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3739
Mailing Address - Country:US
Mailing Address - Phone:408-835-3726
Mailing Address - Fax:
Practice Address - Street 1:10909 WEBB CHAPEL RD # 121
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-3739
Practice Address - Country:US
Practice Address - Phone:408-835-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31420122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist