Most Relevant Information
Provider Data
| NPI Number: | 1003675695 |
| Provider Name: | RAJDEEP K RANDHAWA D.D.S |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 109946 |
Most Important Dates
| Enumeration Date: | 03/15/2024 |
| Last Updated: | 03/15/2024 |
Provider Practice Location
11975 MOUNT VERNON AVE
GRAND TERRACE
CA
923135171
Practice Location Phone/Fax
| Phone: | 9099132870 |
| Fax: |
Provider Mailing Location
11975 MOUNT VERNON AVE
GRAND TERRACE
CA
923135171
Provider Mailing Phone/Fax
| Phone: | 9099132870 |
| Fax: |