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General NPI Number Information
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NPI Number | 1356965610
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Entity Type | Individual
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Provider Name | DEVANGI PAGHDAL
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Gender | Female
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 312 E MAIN ST
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City | MIDDLEBURG
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State | PA
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Zip | 17842-1106
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Country | US
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Telephone | 570-655-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 3521 LAUREL VALLEY LN APT 3521
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City | ENOLA
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State | PA
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Zip | 17025-2103
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Country | US
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Telephone | 954-629-3154
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS042640
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License Number State | PA
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