MEDICARE: JULITA S PATIL DDS INC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1629189063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULITA S PATIL DDS INC

Provider Business Mailing Address
First Line	:	2991 TREAT BLVD STE A
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94518-3604
Country	:	US
Telephone Number	:	925-689-2585
Fax Number	:	925-691-5211

Provider Business Practice Location Address
First Line	:	2991 TREAT BLVD STE A
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94518-3604
Country	:	US
Telephone Number	:	925-689-2585
Fax Number	:	925-691-5211

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CHRISTINA MARIA RODRIGUEZ
Credential	:	DO
Telephone Number	:	925-689-2585

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/31/2019

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