Provider Demographics
NPI:1730415233
Name:DHALIWAL, BALWINDER KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:BALWINDER
Middle Name:KAUR
Last Name:DHALIWAL
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 1:3997 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1263
Mailing Address - Country:US
Mailing Address - Phone:267-909-2795
Mailing Address - Fax:
Practice Address - Street 1:3997 PARK AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1263
Practice Address - Country:US
Practice Address - Phone:267-909-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0101331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice