Healthcare Provider Details

I. General information

NPI: 1598776684
Provider Name (Legal Business Name): MILL PLAZA DENTAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BISHOP RD
BELMONT NH
03220
US

IV. Provider business mailing address

14 BISHOP RD
BELMONT NH
03220
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-3444
  • Fax: 603-528-3453
Mailing address:
  • Phone: 603-524-3444
  • Fax: 603-528-3453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number3032
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3033
License Number StateNH

VIII. Authorized Official

Name: DR. JAY ASHVIN PATEL
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 603-524-3444