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General NPI Number Information
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NPI Number | 1487101192
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Entity Type | Organization
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Legal Business Name | CHARANJIT S UPPAL DDS INC
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Dates
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Enumeration Date | 09/10/2016
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Last Update Date | 09/10/2016
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Provider Practice Location Address
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Address Line | 1191 W TENNYSON RD STE 4
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City | HAYWARD
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State | CA
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Zip | 94544-4454
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Country | US
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Telephone | 510-786-1780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 338
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City | MOUNT EDEN
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State | CA
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Zip | 94557-0338
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Country | US
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Telephone | 510-786-1780
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARANJIT S UPPAL
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Credential | DDS
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Telephone | 510-786-1780
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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 | 45048
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License Number State | CA
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