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General NPI Number Information
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NPI Number | 1407596075
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Entity Type | Individual
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Provider Name | RAVNEETINDER KAUR SANDHU DDS MS
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Gender | Female
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1500 W HEBRON PKWY STE 108
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City | CARROLLTON
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State | TX
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Zip | 75010-6531
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Country | US
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Telephone | 214-731-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 3358 CASTLEWOOD BLVD
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-1833
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Country | US
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Telephone | 817-808-4667
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 37944
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License Number State | TX
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