Most Relevant Information
Provider Data
| NPI Number: | 1003063835 |
| Provider Name: | RANDEEP KAUR DA |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: | 113557 |
Most Important Dates
| Enumeration Date: | 08/22/2008 |
| Last Updated: | 08/22/2008 |
Provider Practice Location
4855 SW WESTERN AVE
BEAVERTON
OR
970053460
Practice Location Phone/Fax
| Phone: | 5036264148 |
| Fax: | 5036264412 |
Provider Mailing Location
15800 SW BULRUSH LN
TIGARD
OR
972232609
Provider Mailing Phone/Fax
| Phone: | 5035244731 |
| Fax: |