Healthcare Provider Details

I. General information

NPI: 1699453480
Provider Name (Legal Business Name): SOHI AND SANDHU DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2447 MISSION AVE STE B
CARMICHAEL CA
95608-4994
US

IV. Provider business mailing address

4208 KNOTTY PINE PL
ROCKLIN CA
95765-5732
US

V. Phone/Fax

Practice location:
  • Phone: 703-618-0194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GUNCHA SOHI
Title or Position: OWNER
Credential: DDS
Phone: 703-618-0194