Provider Demographics
NPI:1659702801
Name:TARSEM SINGHAL A DENTAL CORPORATION
Entity type:Organization
Organization Name:TARSEM SINGHAL A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARSEM
Authorized Official - Middle Name:L
Authorized Official - Last Name:SINGHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-548-6200
Mailing Address - Street 1:5370 SCHAEFER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-9008
Mailing Address - Country:US
Mailing Address - Phone:909-548-6200
Mailing Address - Fax:909-548-6205
Practice Address - Street 1:5370 SCHAEFER AVE STE C
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-9008
Practice Address - Country:US
Practice Address - Phone:909-548-6200
Practice Address - Fax:909-548-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27071305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service