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General NPI Number Information
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NPI Number | 1063731198
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Entity Type | Organization
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Legal Business Name | SHEFALI PANDYA, D.M.D., P.A.
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 707 FOULK RD SUITE 201
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City | WILMINGTON
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State | DE
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Zip | 19803-3737
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Country | US
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Telephone | 302-421-9960
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Fax | 302-421-9970
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Provider Business Mailing Address
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Address Line | 707 FOULK RD SUITE 201
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City | WILMINGTON
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State | DE
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Zip | 19803-3737
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Country | US
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Telephone | 302-421-9960
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Fax | 302-421-9970
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SHEFALI PANDYA
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Credential | DMD
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Telephone | 302-421-9960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | G1-0001124
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License Number State | DE
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