Provider Demographics
NPI:1154570471
Name:BAL, HARSIMRAT KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:HARSIMRAT
Middle Name:KAUR
Last Name:BAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 LORENA CT
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7760
Mailing Address - Country:US
Mailing Address - Phone:510-525-5269
Mailing Address - Fax:
Practice Address - Street 1:5959 GREENBACK LN
Practice Address - Street 2:UNIT 110
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4700
Practice Address - Country:US
Practice Address - Phone:916-723-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA576621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice