Provider Demographics
NPI:1962412130
Name:PANCHAL, DARSHAN J (DDS)
Entity type:Individual
Prefix:DR
First Name:DARSHAN
Middle Name:J
Last Name:PANCHAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:150 SUNRISE HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2598
Mailing Address - Country:US
Mailing Address - Phone:631-226-2525
Mailing Address - Fax:631-226-7715
Practice Address - Street 1:150 SUNRISE HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2598
Practice Address - Country:US
Practice Address - Phone:631-226-2525
Practice Address - Fax:631-226-7715
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0456481223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery