Healthcare Provider Details

I. General information

NPI: 1740107069
Provider Name (Legal Business Name): DR. GURKARAN TOOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10104 FORD AVE STE G
RICHMOND HILL GA
31324-8849
US

IV. Provider business mailing address

255 PENDLETON ST
BAXLEY GA
31513-6910
US

V. Phone/Fax

Practice location:
  • Phone: 912-445-5337
  • Fax:
Mailing address:
  • Phone: 215-933-2614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN124170
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: