Provider Demographics
NPI:1932414091
Name:GURM, PAWANDEEP KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:PAWANDEEP
Middle Name:KAUR
Last Name:GURM
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 1:13523 SOUTH MARKS
Mailing Address - Street 2:
Mailing Address - City:CARUTHERS
Mailing Address - State:CA
Mailing Address - Zip Code:93609
Mailing Address - Country:US
Mailing Address - Phone:559-259-9165
Mailing Address - Fax:
Practice Address - Street 1:1111 E. TULARE AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274
Practice Address - Country:US
Practice Address - Phone:559-358-3093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics