Healthcare Provider Details

I. General information

NPI: 1598053126
Provider Name (Legal Business Name): DHAGASH B PATEL D.M.D, M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WINCHESTER ST
KEENE NH
03431-3940
US

IV. Provider business mailing address

742 DANIEL SHAYS HWY APT B1
ATHOL MA
01331-9330
US

V. Phone/Fax

Practice location:
  • Phone: 603-522-7821
  • Fax:
Mailing address:
  • Phone: 617-416-9512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number04936
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number010682
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS038961
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1855892
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: