Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30021931 | OH |
NPI | 1023101508 |
---|---|
Provider Name | Avneet K Sandhu |
First Address | Pueblo, CO 81003-3111 |
Second Address | Columbus, OH 43229-6601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1777813 | UNITED CONCORDIA (01) | OH |
2527797 | (05) | OH |
9179382 | DORAL (01) | OH |