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General NPI Number Information
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NPI Number | 1053789826
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Entity Type | Organization
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Legal Business Name | RM PATEL DDS, INC.
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 7211 HAVEN AVE STE # D
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-6064
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Country | US
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Telephone | 909-256-8484
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Fax | 909-256-8493
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Provider Business Mailing Address
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Address Line | 7211 HAVEN AVE STE # D
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-6064
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Country | US
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Telephone | 909-256-8484
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Fax | 909-256-8493
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Authorized Official
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Title or Position | CEO
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Name | DR. KEYURKUMAR RATILAL PATEL
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Credential | D.D.S.
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Telephone | 909-267-0970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 54570
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License Number State | CA
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