Provider Demographics
NPI:1992119358
Name:A. SEKHON DENTAL CORPORATION
Entity type:Organization
Organization Name:A. SEKHON DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:DELANY
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-671-9555
Mailing Address - Street 1:3031 W MARCH LN STE 206
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-6567
Mailing Address - Country:US
Mailing Address - Phone:209-594-0485
Mailing Address - Fax:209-594-0720
Practice Address - Street 1:3031 W MARCH LN STE 206
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6567
Practice Address - Country:US
Practice Address - Phone:209-594-0485
Practice Address - Fax:209-594-0720
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A. SEKHON DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54402122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty