Healthcare Provider Details

I. General information

NPI: 1336682459
Provider Name (Legal Business Name): SEKHON AND CHEEMA DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 N WILLOW AVE STE 117
CLOVIS CA
93611-4414
US

IV. Provider business mailing address

1557 E VIA ESTRELLA DR
FRESNO CA
93730-8827
US

V. Phone/Fax

Practice location:
  • Phone: 559-666-3020
  • Fax:
Mailing address:
  • Phone: 916-712-4671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number54402
License Number StateCA

VIII. Authorized Official

Name: DR. AMANDEEP KAUR SEKHON
Title or Position: PRESIDENT
Credential: DMD
Phone: 559-666-3020