MEDICARE: DR. SAMIR ARVIND 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
1	1223G0001X	General Practice Dentistry	44757	CA
2	1223G0001X	General Practice Dentistry	20595	TX

General Provider Information

NPI Number	:	1740286012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMIR ARVIND PATEL D.D.S.

Provider Business Mailing Address
First Line	:	401 S TENNESSEE ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-5621
Country	:	US
Telephone Number	:	972-542-3324
Fax Number	:	972-542-4663

Provider Business Practice Location Address
First Line	:	401 S TENNESSEE ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-5621
Country	:	US
Telephone Number	:	972-542-3324
Fax Number	:	972-542-3324

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/07/2009

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