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NPI 1073984431

NPI 1073984431 : KINNARI PATEL D.D.S : SUNNYVALE, CA

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General NPI Number Information
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    NPI Number           |    1073984431
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    Entity Type          |    Individual 
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    Provider Name        |    KINNARI PATEL D.D.S
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/12/2015
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    Last Update Date     |    10/12/2015
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Provider Practice Location Address
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    Address Line         |    672 MONTARA TERRACE 
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    City                 |    SUNNYVALE
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    State                |    CA
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    Zip                  |    94085
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    Country              |    US
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    Telephone            |    734-674-0627
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    672 MONTARA TER 
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    City                 |    SUNNYVALE
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    State                |    CA
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    Zip                  |    94085-3872
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    Country              |    US
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    Telephone            |    734-674-0627
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    64897
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    License Number State |    CA
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