Provider Demographics
NPI:1154878486
Name:SINGH IM PLLC
Entity type:Organization
Organization Name:SINGH IM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKRAMPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-333-9500
Mailing Address - Street 1:1030 OUTLET COLLECTION WAY SW
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-6537
Mailing Address - Country:US
Mailing Address - Phone:253-333-9500
Mailing Address - Fax:253-333-9503
Practice Address - Street 1:1030 OUTLET COLLECTION WAY SW
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-6537
Practice Address - Country:US
Practice Address - Phone:253-333-9500
Practice Address - Fax:253-333-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60341120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty