Healthcare Provider Details

I. General information

NPI: 1972958635
Provider Name (Legal Business Name): MEENAL H PATEL DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 MCDONALD AVE
CHARLOTTE NC
28203-5321
US

IV. Provider business mailing address

513 MCDONALD AVE
CHARLOTTE NC
28203-5321
US

V. Phone/Fax

Practice location:
  • Phone: 352-678-1453
  • Fax:
Mailing address:
  • Phone: 352-678-1453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MEENAL H PATEL
Title or Position: PRESIDNET
Credential: DMD
Phone: 352-678-1453