Organization Name: | CHHINA DENTAL GROUP |
NPI Number: | 1013390483 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MUNDEEP SINGH CHHINA (PRESIDENT) |
Mailing Address: | 1310 Tara Hills Dr Ste F Pinole |
State: | CA US |
Postal Code: | 945642533 |
Phone Number: | 5107246900 |
Fax Number: | 5107242707 |
NPI Enumeration Date: | 07/03/2015 |
NPI Last Update Date: | 07/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 3799799 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |