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General NPI Number Information
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NPI Number | 1013355841
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Entity Type | Individual
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Provider Name | GAGANDEEP SINGH KANDOLA D.M.D
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Gender | Male
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 9620 COUNTRY ROADS DR
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City | SACRAMENTO
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State | CA
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Zip | 95827-3214
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Country | US
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Telephone | 916-730-3674
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Fax |
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Provider Business Mailing Address
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Address Line | 9620 COUNTRY ROADS DR
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City | SACRAMENTO
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State | CA
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Zip | 95827-3214
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Country | US
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Telephone | 916-730-3674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62429
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License Number State | CA
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