MEDICARE: DR. JYOTI PATEL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS030591L	PA

General Provider Information

NPI Number	:	1063674232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JYOTI PATEL DMD

Provider Business Mailing Address
First Line	:	2303 REDTAIL RD
Second Line	:
City	:	EAGLEVILLE
State	:	PA
Zip	:	19403-1873
Country	:	US
Telephone Number	:	610-323-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 HERITAGE DR
Second Line	:	SIUTE 802
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-9220
Country	:	US
Telephone Number	:	610-323-9030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	06/30/2008

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