Provider Demographics
NPI:1780357335
Name:SINGH, AMARJOT (BDS, MSC)
Entity type:Individual
Prefix:DR
First Name:AMARJOT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:BDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1982 LOVEJOY AVE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-2030
Mailing Address - Country:US
Mailing Address - Phone:209-402-7648
Mailing Address - Fax:
Practice Address - Street 1:207 N BUTTE ST
Practice Address - Street 2:
Practice Address - City:WILLOWS
Practice Address - State:CA
Practice Address - Zip Code:95988-2803
Practice Address - Country:US
Practice Address - Phone:530-934-4641
Practice Address - Fax:530-934-4916
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107202122300000X
VA0401417605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist