Provider Demographics
NPI:1396057642
Name:DHILLON, AZALPREET (BDS)
Entity type:Individual
Prefix:DR
First Name:AZALPREET
Middle Name:
Last Name:DHILLON
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5495 HEDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-5833
Mailing Address - Country:US
Mailing Address - Phone:440-372-0713
Mailing Address - Fax:
Practice Address - Street 1:18660 BAGLEY ROAD
Practice Address - Street 2:MEDICAL ARTS BUILDING 2 SUITE 304
Practice Address - City:MIDDLEBURG HTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-826-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0238381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30.023838OtherOHIO STATE DENTIST LICENSE NUMBER