Provider Demographics
NPI:1649468539
Name:MAKKAR, PARUL DUA (DDS)
Entity type:Individual
Prefix:DR
First Name:PARUL
Middle Name:DUA
Last Name:MAKKAR
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 1:12102 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:S RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419
Mailing Address - Country:US
Mailing Address - Phone:718-641-1160
Mailing Address - Fax:718-641-1167
Practice Address - Street 1:12102 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:S RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419
Practice Address - Country:US
Practice Address - Phone:718-641-1160
Practice Address - Fax:718-641-1167
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053657-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist