Healthcare Provider Details

I. General information

NPI: 1619677853
Provider Name (Legal Business Name): HASMI RAMESH PATEL, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4514 OLD MONROE RD STE E
INDIAN TRAIL NC
28079-5308
US

IV. Provider business mailing address

4514 OLD MONROE RD STE E
INDIAN TRAIL NC
28079-5308
US

V. Phone/Fax

Practice location:
  • Phone: 704-839-2434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HASMI PATEL
Title or Position: OWNER
Credential: DMD
Phone: 828-551-3431