Provider Demographics
NPI:1245450667
Name:PALL, RACHNA (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHNA
Middle Name:
Last Name:PALL
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 1:2323 MONTPELIER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1611
Mailing Address - Country:US
Mailing Address - Phone:408-258-4040
Mailing Address - Fax:
Practice Address - Street 1:2323 MONTPELIER DR
Practice Address - Street 2:SUITE B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1611
Practice Address - Country:US
Practice Address - Phone:408-258-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA509661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice