Healthcare Provider Details

I. General information

NPI: 1780712638
Provider Name (Legal Business Name): ALPA J PATEL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURT ST SUITE #270
LEBANON NH
03766-1358
US

IV. Provider business mailing address

1 COURT ST SUITE #270
LEBANON NH
03766-1358
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-1830
  • Fax: 603-448-1826
Mailing address:
  • Phone: 603-448-1830
  • Fax: 603-448-1826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number03781
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: