Provider Demographics
NPI:1104495316
Name:KAUR, GURPREET (DENTIST)
Entity type:Individual
Prefix:DR
First Name:GURPREET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 MEDFORD RD APT 261
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4951
Mailing Address - Country:US
Mailing Address - Phone:214-971-6882
Mailing Address - Fax:
Practice Address - Street 1:20720 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1275
Practice Address - Country:US
Practice Address - Phone:313-342-1997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty