MEDICARE: DR. RAMANDEEP KAUR DHALIWAL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30020969	OH

General Provider Information

NPI Number	:	1649329616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMANDEEP KAUR DHALIWAL DMD

Provider Business Mailing Address
First Line	:	2132 E 3RD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1930
Country	:	US
Telephone Number	:	937-208-6875
Fax Number	:

Provider Business Practice Location Address
First Line	:	2132 E 3RD ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45403-1930
Country	:	US
Telephone Number	:	937-208-6875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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