Provider Demographics
NPI:1144654740
Name:RAJVIR SINGH BHOGAL DDS INC
Entity type:Organization
Organization Name:RAJVIR SINGH BHOGAL DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJVIR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHOGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-797-2840
Mailing Address - Street 1:37070 NEWARK BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3798
Mailing Address - Country:US
Mailing Address - Phone:510-797-2840
Mailing Address - Fax:510-797-2841
Practice Address - Street 1:37070 NEWARK BLVD STE C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3798
Practice Address - Country:US
Practice Address - Phone:510-797-2840
Practice Address - Fax:510-797-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty