Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN17702 | FL |
NPI | 1003086612 |
---|---|
Provider Name | Ajay R. Singh |
First Address | Stuart, FL 34994 |
Second Address | Stuart, FL 34994-4531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 11/03/2008 |