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NPI Code Detail

MEDICARE: DR. MANISHA VRAJESH PATEL D.D.S.

MEDICARE:  DR. MANISHA VRAJESH PATEL  D.D.S.
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
1122300000XDentist2901015961MI

General Provider Information

NPI Number : 1104082916
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANISHA VRAJESH PATEL D.D.S.
Provider Business Mailing Address
First Line : 6053 ROCHESTER RD
Second Line :
City : TROY
State : MI
Zip : 48085-1303
Country : US
Telephone Number : 248-879-5858
Fax Number :
Provider Business Practice Location Address
First Line : 6053 ROCHESTER RD
Second Line :
City : TROY
State : MI
Zip : 48085-1303
Country : US
Telephone Number : 248-879-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2008
Last Update Date : 07/31/2008

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Directions to “ DR. MANISHA VRAJESH PATEL D.D.S.” Practice Location

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