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General NPI Number Information
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NPI Number | 1760061436
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Entity Type | Organization
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Legal Business Name | RAMANDEEP K GILL DDS INC.
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 1148 S MAIN ST
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City | MANTECA
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State | CA
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Zip | 95337-9505
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Country | US
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Telephone | 209-249-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 1548 MAEHL DR
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City | MANTECA
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State | CA
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Zip | 95337-7215
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Country | US
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Telephone | 925-818-9455
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | RAMANDEEP GILL
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Credential | DDS
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Telephone | 925-818-9455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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