MEDICARE: DR. AMARJOT SINGH 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	1223P0221X	Pediatric Dentistry	DS039886	PA
2	1223P0221X	Pediatric Dentistry	22DI02567600	NJ

General Provider Information

NPI Number	:	1952676801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMARJOT SINGH D.D.S.

Provider Business Mailing Address
First Line	:	2216 CORAL ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1512
Country	:	US
Telephone Number	:	862-228-4531
Fax Number	:

Provider Business Practice Location Address
First Line	:	2675 E CUMBERLAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-3727
Country	:	US
Telephone Number	:	862-228-4531
Fax Number	:

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

Provider Enumeration Date	:	03/11/2012
Last Update Date	:	10/27/2015

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