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General NPI Number Information
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NPI Number | 1366870693
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Entity Type | Organization
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Legal Business Name | GURMINDER S. UPPAL, DDS DENTAL CORP.
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 1807 CENTRAL AVE
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City | CERES
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State | CA
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Zip | 95307-1806
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Country | US
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Telephone | 209-537-7357
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Fax |
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Provider Business Mailing Address
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Address Line | 3221 MADDEN WAY
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City | DUBLIN
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State | CA
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Zip | 94568-7216
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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 | OWNER
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Name | DR. GURMINDER SIDHU UPPAL
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Credential | D.D.S, M.S
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Telephone | 415-810-4541
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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 | 56914
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License Number State | CA
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