Provider Demographics
NPI:1194964585
Name:SUNDERPAL S DAIL, DDS, INC
Entity type:Organization
Organization Name:SUNDERPAL S DAIL, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNDERPAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-373-2055
Mailing Address - Street 1:337 EL DORADO ST
Mailing Address - Street 2:B-2
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4647
Mailing Address - Country:US
Mailing Address - Phone:831-373-2055
Mailing Address - Fax:831-373-0932
Practice Address - Street 1:337 EL DORADO ST
Practice Address - Street 2:B-2
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4647
Practice Address - Country:US
Practice Address - Phone:831-373-2055
Practice Address - Fax:831-373-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530581223P0221X
CA461741223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty