MEDICARE: SURINDERPAL SINGH 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	34092	TX

General Provider Information

NPI Number	:	1942793401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SURINDERPAL SINGH DMD

Provider Business Mailing Address
First Line	:	9170 SAGEWOOD DR APT 5209
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-2346
Country	:	US
Telephone Number	:	817-793-0051
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 MCCART AVE STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-7427
Country	:	US
Telephone Number	:	817-529-6300
Fax Number	:

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

Provider Enumeration Date	:	06/10/2018
Last Update Date	:	06/10/2018

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