Kohli Professional Dental Corporation
Clinic/Center, Dental in Fremont, CA. Organization (NPI-2).
NPI number1124806039
StatusActive
Last updated in NPPESSep 20, 2023
Details
- NPI
- 1124806039
- Entity type
- Organization (NPI-2)
- Legal business name
- Kohli Professional Dental Corporation
- Organization subpart
- No
- Enumeration date
- Sep 20, 2023
- Certification date
- Sep 20, 2023
- Last updated
- Sep 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Fremont Family Dental Group (Doing Business As)
Practice location
2243 Mowry Ave Ste CFremont, CA 94538-1630
Phone 510-792-9084 · Fax 510-792-9620
Mailing address
2243 Mowry Ave Ste CFremont, CA 94538-1630
Phone 510-792-9084 · Fax 510-792-9620
Authorized official
Gagandeep Kohli
President
5107929084
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