MEDICARE: PUNEET SANDHU

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	60766	CA

General Provider Information

NPI Number	:	1912287004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUNEET SANDHU

Provider Business Mailing Address
First Line	:	610 TERESI LN
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94024-4161
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 TERESI LN
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94024-4161
Country	:	US
Telephone Number	:	714-220-7773
Fax Number	:

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

Provider Enumeration Date	:	08/22/2011
Last Update Date	:	08/22/2011

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Directions to “ PUNEET SANDHU ” Practice Location

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