Provider Demographics
NPI:1942299094
Name:POCHAL, WILLIAM F JR (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:POCHAL
Suffix:JR
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2636
Mailing Address - Country:US
Mailing Address - Phone:607-733-3760
Mailing Address - Fax:607-734-6000
Practice Address - Street 1:451 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2636
Practice Address - Country:US
Practice Address - Phone:607-733-3760
Practice Address - Fax:607-734-6000
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179531-11223S0112X
NY037940-11223S0112X
PADS027745L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
38183BMedicare ID - Type UnspecifiedCORNING, NY OFFICE
38182EMedicare ID - Type UnspecifiedELMIRA, NY OFFICE
U01869Medicare UPIN
53025CMedicare ID - Type UnspecifiedWAVERLY, NY OFFICE