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General NPI Number Information
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NPI Number | 1710598271
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Entity Type | Individual
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Provider Name | AMANDEEP KAUR BRAR DDS
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1507 W YOSEMITE AVE
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City | MANTECA
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State | CA
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Zip | 95337-5182
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Country | US
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Telephone | 209-914-0659
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Fax |
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Provider Business Mailing Address
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Address Line | 2419 NORTHINGTON DR
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City | TRACY
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State | CA
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Zip | 95377-8469
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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 |
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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 | 019032868
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License Number State | IL
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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 | DDS105397
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License Number State | CA
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