Organization
AESTHETIC EDGE, THE DENTAL PRACTICE OF MANKIRAT GILL DDS PROF. CORP.
Active
Other names
Aesthetic Edge Dentistry PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANWAR GILL MD (SECRETARY)
(559) 447-8490
Entity
Organization
Contact information
Practice address
3616 W SHAW AVE, FRESNO, CA 93711-3231
(559) 271-8400
(559) 271-8401
Mailing address
3616 W SHAW AVE, FRESNO, CA 93711-3231
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
58363
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58363
DENTAL LICENSE OF MANKIRAT GILL DDS
CA
Enumeration date
12/02/2010
Last updated
11/30/2012
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