Healthcare Provider Details

I. General information

NPI: 1306020847
Provider Name (Legal Business Name): AMERICAN DENTAL CARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 CONCHESTER HIGHWAY SUITE 8 AMERICAN DENTAL CARE LLC
GARNET VALLEY PA
19061-2105
US

IV. Provider business mailing address

1440 CONCHESTER HIGHWAY SUITE 8 AMERICAN DENTAL CARE,LLC
GARNET VALLEY PA
19061-2105
US

V. Phone/Fax

Practice location:
  • Phone: 610-459-0845
  • Fax: 610-558-2449
Mailing address:
  • Phone: 610-459-0845
  • Fax: 610-558-2449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS 020804-L
License Number StatePA

VIII. Authorized Official

Name: DR. PRAFUL G PATEL
Title or Position: PRESIDENT
Credential: DDS
Phone: 267-221-6070