Provider Demographics
NPI:1003086612
Name:SINGH, AJAY R (DDS)
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:R
Last Name:SINGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2474 S. FEDERAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-220-7555
Mailing Address - Fax:772-220-1016
Practice Address - Street 1:2474 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4531
Practice Address - Country:US
Practice Address - Phone:772-220-7555
Practice Address - Fax:772-220-1016
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17702122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist