Provider Demographics
NPI:1821215146
Name:PAL, VALSALA A (DDS)
Entity Type:Individual
Prefix:
First Name:VALSALA
Middle Name:A
Last Name:PAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 UNION CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-1115
Mailing Address - Country:US
Mailing Address - Phone:703-444-4188
Mailing Address - Fax:703-444-4309
Practice Address - Street 1:46161 WESTLAKE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-444-4188
Practice Address - Fax:703-444-4309
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401004565122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist