Provider Demographics
NPI:1972263499
Name:SINGH, IQBAL (DENTURIST)
Entity type:Individual
Prefix:MR
First Name:IQBAL
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DENTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13324 27TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3809
Mailing Address - Country:US
Mailing Address - Phone:206-482-9200
Mailing Address - Fax:
Practice Address - Street 1:30818 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4902
Practice Address - Country:US
Practice Address - Phone:253-528-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60596321122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist