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General NPI Number Information
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NPI Number | 1801003645
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Entity Type | Organization
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Legal Business Name | PARAG R. KACHALIA, DDS., INC.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 525 BOLLINGER CANYON WAY STE 100
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City | SAN RAMON
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State | CA
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Zip | 94582-4935
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Country | US
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Telephone | 925-362-8209
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Fax |
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Provider Business Mailing Address
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Address Line | 525 BOLLINGER CANYON WAY STE 100
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City | SAN RAMON
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State | CA
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Zip | 94582-4935
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Country | US
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Telephone | 925-362-8209
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Fax | 925-362-0217
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DR. PARAG R KACHALIA
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Credential | DDS
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Telephone | 925-362-8209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 48926
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License Number State | CA
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