Provider Demographics
NPI:1104685999
Name:RAJWANT KAUR BHATTI DENTAL CORP
Entity type:Organization
Organization Name:RAJWANT KAUR BHATTI DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RAJWANT
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:SANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-866-4289
Mailing Address - Street 1:4639 MARGARET ADELE LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8865
Mailing Address - Country:US
Mailing Address - Phone:206-866-4289
Mailing Address - Fax:
Practice Address - Street 1:2222 EAST ST STE 270
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2066
Practice Address - Country:US
Practice Address - Phone:206-866-4289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty