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General NPI Number Information
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NPI Number | 1003555921
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Entity Type | Individual
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Provider Name | DARSHAN MAYUR PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 117 PAVILION PKWY
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7732
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Country | US
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Telephone | 770-953-6975
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Fax |
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Provider Business Mailing Address
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Address Line | 905 CAROLINUS CT
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City | MCDONOUGH
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State | GA
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Zip | 30253-8008
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Country | US
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Telephone | 832-477-1298
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN122757
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License Number State | GA
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