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General NPI Number Information
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NPI Number | 1679822860
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Entity Type | Individual
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Provider Name | HARKESHWAR S SANDHU
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Gender | Male
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 3171 WASHINGTON ST SUITE B
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City | PLACERVILLE
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State | CA
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Zip | 95667-5831
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Country | US
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Telephone | 530-626-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 5517 ENSEMBLE WAY
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City | ROSEVILLE
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State | CA
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Zip | 95747-8939
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Country | US
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Telephone | 703-618-6550
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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 | DS039433
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License Number State | PA
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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 | 64180
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License Number State | CA
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