# MANN PACIFIC DENTAL, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366039539
- **Authorized official:** ASHAM DEEP KAUR (CEO)
- **Authorized official phone:** (510) 378-9802

## Contact information

- **Practice address:** 1630 S PACIFIC AVE STE 104, YUMA, AZ 85365-2111
- **Practice address phone:** (510) 378-9802
- **Practice address fax:** (928) 783-0846
- **Mailing address:** 1630 S PACIFIC AVE STE 104, YUMA, AZ 85365-2111
- **Mailing address phone:** (510) 378-9802
- **Mailing address fax:** (928) 783-0846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/22/2020
- **Last updated:** 12/22/2020