Provider Demographics
NPI:1730240987
Name:KAUR, JAGDEEP (DMD)
Entity type:Individual
Prefix:DR
First Name:JAGDEEP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 AVALON WAY
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7784
Mailing Address - Country:US
Mailing Address - Phone:508-209-2501
Mailing Address - Fax:508-540-5520
Practice Address - Street 1:210 JONES RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2907
Practice Address - Country:US
Practice Address - Phone:508-540-0303
Practice Address - Fax:508-540-5520
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice