Provider Demographics
NPI:1649319765
Name:CHAHAL, GURNEET (DDS)
Entity type:Individual
Prefix:MRS
First Name:GURNEET
Middle Name:
Last Name:CHAHAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S OAK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-3572
Mailing Address - Country:US
Mailing Address - Phone:209-322-3174
Mailing Address - Fax:209-322-3183
Practice Address - Street 1:250 S OAK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-3572
Practice Address - Country:US
Practice Address - Phone:209-322-3174
Practice Address - Fax:209-322-3183
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice