Healthcare Provider Details

I. General information

NPI: 1245123777
Provider Name (Legal Business Name): CHIRAG RAMESH PANCHAL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SW 34TH AVE STE 600
OCALA FL
34474-8476
US

IV. Provider business mailing address

7278 SW 90TH LOOP UNIT 101
OCALA FL
34476-5828
US

V. Phone/Fax

Practice location:
  • Phone: 352-861-2510
  • Fax:
Mailing address:
  • Phone: 727-454-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN30335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: