Provider Demographics
NPI:1871967497
Name:SEHGAL, PARAG (DDS)
Entity type:Individual
Prefix:DR
First Name:PARAG
Middle Name:
Last Name:SEHGAL
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 1:1245 BOSTON RD
Mailing Address - Street 2:SPRINGFIELD
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1328
Mailing Address - Country:US
Mailing Address - Phone:562-552-4954
Mailing Address - Fax:
Practice Address - Street 1:1245 BOSTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119-1328
Practice Address - Country:US
Practice Address - Phone:203-575-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2.0116641223G0001X, 1223G0001X
MADN18574311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice