Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 60016824 | WA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 60027252 | WA |
NPI | 1144396763 |
---|---|
Provider Name | Dr. Sukhdeep Singh Dhaliwal |
First Address | Silverdale, WA 98383-8562 |
Second Address | Poulsbo, WA 98370-7529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 05/01/2012 |