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General NPI Number Information
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NPI Number | 1174794747
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Entity Type | Organization
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Legal Business Name | KISH PATEL, DDS, PA
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 5303 POPLAR TENT RD SUITE 240
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City | CONCORD
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State | NC
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Zip | 28027-9720
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Country | US
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Telephone | 704-795-1515
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Fax | 704-795-1516
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Provider Business Mailing Address
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Address Line | 2757 ISLAND POINT DR NW
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City | CONCORD
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State | NC
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Zip | 28027-2536
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Country | US
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Telephone | 704-262-3726
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KISHOR B PATEL
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Credential | DDS
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Telephone | 704-795-1515
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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 | 7313
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License Number State | NC
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