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Individual

TAREN PANNU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
229 TEWKSBURY AVE STE A, POINT RICHMOND, CA 94801-3829
(415) 755-5549
Mailing address
16 WOODSTOCK CT, SAN RAFAEL, CA 94903-4619
(415) 755-5549

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP714
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RDHAP714
DHCC
CA
Enumeration date
12/28/2018
Last updated
12/28/2018
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