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General NPI Number Information
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NPI Number | 1891041349
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Entity Type | Individual
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Provider Name | MANPREET KAUR RANDHAWA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 300 WESTGATE WAY
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City | DINUBA
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State | CA
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Zip | 93618-9693
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Country | US
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Telephone | 800-492-4227
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Fax | 831-918-0928
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Provider Business Mailing Address
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Address Line | 3875 W BEECHWOOD AVE
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City | FRESNO
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State | CA
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Zip | 93711-0795
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Country | US
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Telephone | 800-492-4227
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Fax | 559-646-3652
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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 | DDS102017
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License Number State | CA
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