Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS020885L | PA |
NPI | 1043329311 |
---|---|
Provider Name | Dr. Gurbhajan Singh |
First Address | Fort Eustis, VA 23694-5311 |
Second Address | Fort Eustis, VA 23694-5311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |