MEDICARE: DR. SIMERDEEP KAUR GILL 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	1223G0001X	General Practice Dentistry	62170	CA

General Provider Information

NPI Number	:	1912246810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMERDEEP KAUR GILL DDS

Provider Business Mailing Address
First Line	:	9446 N PRICE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-4168
Country	:	US
Telephone Number	:	559-360-2491
Fax Number	:

Provider Business Practice Location Address
First Line	:	434 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-2511
Country	:	US
Telephone Number	:	559-226-2211
Fax Number	:

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

Provider Enumeration Date	:	02/12/2013
Last Update Date	:	01/17/2019

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