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Organization
KOHLI DDS INC
Active
Organization
KOHLI DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAGANDEEP KOHLI (PRESIDENT)
(510) 276-6930
Entity
Organization
Contact information
Practice address
16177 HESPERIAN BLVD, SAN LORENZO, CA 94580-2451
(510) 276-6930
Mailing address
16177 HESPERIAN BLVD, SAN LORENZO, CA 94580-2451
(510) 276-6930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
49124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902963051
NPI
CA
Enumeration date
07/29/2014
Last updated
07/29/2016
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