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General NPI Number Information
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NPI Number | 1740443175
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Entity Type | Individual
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Provider Name | RUPAUL SINGH GHUMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 1114 YUBA ST STE 220
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City | MARYSVILLE
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State | CA
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Zip | 95901-4838
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Country | US
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Telephone | 530-749-3242
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 YUBA ST STE 220
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City | MARYSVILLE
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State | CA
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Zip | 95901-4838
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Country | US
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Telephone | 530-749-3242
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 57080
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License Number State | CA
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