MEDICARE: DR. HARJOT KAUR BAINS D.D.S.

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	1223G0001X	General Practice Dentistry	D6387	AZ

General Provider Information

NPI Number	:	1720192578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARJOT KAUR BAINS D.D.S.

Provider Business Mailing Address
First Line	:	10630 N 59TH AVE
Second Line	:	SUITE101
City	:	GLENDALE
State	:	AZ
Zip	:	85304-1239
Country	:	US
Telephone Number	:	623-878-0117
Fax Number	:	623-878-6396

Provider Business Practice Location Address
First Line	:	10630 N 59TH AVE
Second Line	:	SUITE101
City	:	GLENDALE
State	:	AZ
Zip	:	85304-1239
Country	:	US
Telephone Number	:	623-878-0117
Fax Number	:	623-878-6396

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	05/02/2022

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