MEDICARE: DR. SHIVANI H PATEL D.M.D.

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	03689	NH

General Provider Information

NPI Number	:	1336390384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIVANI H PATEL D.M.D.

Provider Business Mailing Address
First Line	:	5 HITCHING POST LN
Second Line	:
City	:	METHUEN
State	:	MA
Zip	:	01844-2695
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	71 ROUTE 101A
Second Line	:
City	:	AMHERST
State	:	NH
Zip	:	03031-2274
Country	:	US
Telephone Number	:	603-672-6546
Fax Number	:

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

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	10/08/2008

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