Provider Demographics
NPI:1457969669
Name:KAUR, MANVIR (DDS)
Entity type:Individual
Prefix:
First Name:MANVIR
Middle Name:
Last Name:KAUR
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 1:1979 SW 41ST LN
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-6894
Mailing Address - Country:US
Mailing Address - Phone:253-330-7138
Mailing Address - Fax:
Practice Address - Street 1:48 NE 11TH ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1865
Practice Address - Country:US
Practice Address - Phone:541-777-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61085507122300000X
ORD12023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist