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General NPI Number Information
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NPI Number | 1184609745
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Entity Type | Individual
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Provider Name | DAMANJIT SINGH GILL DDS
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 2242 W GRANT LINE RD SUITE#102
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City | TRACY
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State | CA
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Zip | 95377-7329
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Country | US
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Telephone | 209-832-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 2242 W GRANT LINE RD SUITE#102
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City | TRACY
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State | CA
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Zip | 95377-7329
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Country | US
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Telephone | 209-832-2525
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52608
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License Number State | CA
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