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NPI 1083632475

NPI 1083632475 : RITA T PATEL D.D.S. : WESTLAND, MI

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General NPI Number Information
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    NPI Number           |    1083632475
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    Entity Type          |    Individual 
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    Provider Name        |    RITA T PATEL D.D.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/17/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    8010 N WAYNE RD 
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    City                 |    WESTLAND
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    State                |    MI
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    Zip                  |    48185-1110
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    Country              |    US
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    Telephone            |    734-522-6128
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    Fax                  |    734-522-6390
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Provider Business Mailing Address
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    Address Line         |    8010 N WAYNE RD 
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    City                 |    WESTLAND
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    State                |    MI
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    Zip                  |    48185-1110
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    Country              |    US
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    Telephone            |    734-522-6128
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    Fax                  |    734-522-6390
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    2901017504
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    License Number State |    MI
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