Provider Demographics
NPI:1639747421
Name:TORAL PANDYA PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:TORAL PANDYA PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TORAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANDYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-918-0162
Mailing Address - Street 1:7471 WATT AVE STE 107A
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-2632
Mailing Address - Country:US
Mailing Address - Phone:310-918-0162
Mailing Address - Fax:
Practice Address - Street 1:7471 WATT AVE STE 107A
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-2632
Practice Address - Country:US
Practice Address - Phone:310-918-0162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61928OtherDENTIST