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General NPI Number Information
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NPI Number | 1033385323
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Entity Type | Individual
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Provider Name | NAWANDEEP KALRA DDS
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Gender | Female
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 02/01/2009
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Provider Practice Location Address
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Address Line | 19333 US ROUTE 11 OUTER WASHINGTON STREET
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City | WATERTOWN
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State | NY
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Zip | 13601-5317
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Country | US
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Telephone | 315-788-7070
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Fax | 315-788-6927
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Provider Business Mailing Address
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Address Line | 16582 DEER RUN RD
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City | WATERTOWN
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State | NY
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Zip | 13601-5842
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Country | US
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Telephone | 315-767-0029
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Fax | 315-788-6927
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | P58567
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 59 000079
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License Number State | NY
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