Provider Demographics
NPI:1740547504
Name:GOPAL S. PAL DDS. MS
Entity type:Organization
Organization Name:GOPAL S. PAL DDS. MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-642-2828
Mailing Address - Street 1:7540 LITTLE RIVER TURNPIKE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003
Mailing Address - Country:US
Mailing Address - Phone:703-642-2828
Mailing Address - Fax:703-642-0209
Practice Address - Street 1:7540 LITTLE RIVER TURNPIKE
Practice Address - Street 2:SUITE A
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-642-2828
Practice Address - Fax:703-642-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty