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General NPI Number Information
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NPI Number | 1205514809
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Entity Type | Individual
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Provider Name | MANPREET KAUR DMD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 946 S WATSON RD STE 101
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City | BUCKEYE
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State | AZ
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Zip | 85326-3430
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Country | US
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Telephone | 623-267-4676
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Fax |
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Provider Business Mailing Address
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Address Line | 5302 SMITTEN ST UNIT 2
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City | YAKIMA
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State | WA
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Zip | 98908-2166
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Country | US
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Telephone | 661-340-4173
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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 | RR61435858
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License Number State | WA
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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 | D012370
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License Number State | AZ
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