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General NPI Number Information
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NPI Number | 1184296956
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Entity Type | Individual
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Provider Name | SUGANDHA SINGH DMD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 4070 LAVISTA RD
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City | TUCKER
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State | GA
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Zip | 30084-5228
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Country | US
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Telephone | 770-225-0723
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Fax |
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Provider Business Mailing Address
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Address Line | 716 CREEKSIDE BND
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City | ALPHARETTA
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State | GA
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Zip | 30004-5426
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Country | US
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Telephone |
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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 | DN123237
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11657
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License Number State | TN
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