Provider Demographics
NPI:1053402313
Name:SINGH, SUNIL K (DMD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:K
Last Name:SINGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 WHITE ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7901
Mailing Address - Country:US
Mailing Address - Phone:770-422-6521
Mailing Address - Fax:317-721-7662
Practice Address - Street 1:1103 GABLES DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-4190
Practice Address - Country:US
Practice Address - Phone:317-721-7662
Practice Address - Fax:317-721-7662
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014527122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist