Organization
PANCHOLI DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVAKSHI PANCHOLI DDS (DENTIST)
(443) 763-0754
Entity
Organization
Contact information
Practice address
3450 LAUREL FORT MEADE RD STE 202, LAUREL, MD 20724-2040
(443) 763-0754
Mailing address
7207 BARRY LN, ELKRIDGE, MD 21075-5486
(443) 763-0754
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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