Provider Demographics
NPI:1265153845
Name:CHAHAL, PAUL SINGH (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SINGH
Last Name:CHAHAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 FLEUR DE LIS DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9300
Mailing Address - Country:US
Mailing Address - Phone:209-262-5968
Mailing Address - Fax:
Practice Address - Street 1:1520 FULKERTH RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-6884
Practice Address - Country:US
Practice Address - Phone:209-634-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107992122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist