Healthcare Provider Details

I. General information

NPI: 1689580508
Provider Name (Legal Business Name): BRAR DENTAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAMERON PARK DR
CAMERON PARK CA
95682-7914
US

IV. Provider business mailing address

1871 PETITE SYRAH LN
ROSEVILLE CA
95747-6684
US

V. Phone/Fax

Practice location:
  • Phone: 530-672-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. PRATEEK S BRAR
Title or Position: PRESIDENT
Credential: DDS
Phone: 209-617-4193