Healthcare Provider Details

I. General information

NPI: 1316371438
Provider Name (Legal Business Name): R. PATEL DDS & S. PATEL DDS, A DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 MAGNOLIA AVE STE K
CORONA CA
92879-3218
US

IV. Provider business mailing address

1185 MAGNOLIA AVE STE K
CORONA CA
92879-3218
US

V. Phone/Fax

Practice location:
  • Phone: 951-898-8511
  • Fax: 951-898-6939
Mailing address:
  • Phone: 951-898-8511
  • Fax: 951-898-6939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAKESH PATEL
Title or Position: OWNER
Credential: D.D.S.
Phone: 951-898-8845