Provider Demographics
NPI:1588381438
Name:ANNA G UPPAL DDS CORP
Entity type:Organization
Organization Name:ANNA G UPPAL DDS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:GILL
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-387-3113
Mailing Address - Street 1:3581 TERRA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9373
Mailing Address - Country:US
Mailing Address - Phone:408-387-3113
Mailing Address - Fax:
Practice Address - Street 1:1568 CREEKSIDE DR STE 101
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3449
Practice Address - Country:US
Practice Address - Phone:408-387-3113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental