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General NPI Number Information
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NPI Number | 1154767481
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Entity Type | Individual
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Provider Name | MANTHAN HARSHADBHAI PATEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 1930 E PARK ROW DR
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City | ARLINGTON
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State | TX
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Zip | 76010-4744
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Country | US
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Telephone | 817-801-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 LAKE CAROLYN PKWY APT 2314
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City | IRVING
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State | TX
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Zip | 75039-3928
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Country | US
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Telephone | 305-322-7539
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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 | 28820
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License Number State | TX
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