MEDICARE: DR. HARJYOT KAUR BHULLAR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30.025202	OH

General Provider Information

NPI Number	:	1588016083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARJYOT KAUR BHULLAR DDS

Provider Business Mailing Address
First Line	:	7111 N MAIN ST STE 40
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2558
Country	:	US
Telephone Number	:	937-274-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	7111 N MAIN ST STE 40
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2558
Country	:	US
Telephone Number	:	937-274-1127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	03/23/2020

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