Provider Demographics
NPI:1144041013
Name:SANDHU DENTAL PLLC
Entity type:Organization
Organization Name:SANDHU DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRABHDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-560-3380
Mailing Address - Street 1:4909 NORTH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1808
Mailing Address - Country:US
Mailing Address - Phone:936-560-3380
Mailing Address - Fax:936-560-3394
Practice Address - Street 1:4909 NORTH ST STE 210
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1808
Practice Address - Country:US
Practice Address - Phone:936-560-3380
Practice Address - Fax:936-560-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty