Individual
MANSIMRAN SANDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4512 PARNELL AVE, FORT WAYNE, IN 46825-5836
(260) 238-8899
Mailing address
15299 WRIGLEY CT, FORT WAYNE, IN 46814-7614
(408) 621-4856
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013233A
IN
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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