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General NPI Number Information
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NPI Number | 1215166186
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Entity Type | Organization
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Legal Business Name | MUKTAJEEVAN DENTAL LLC
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 31B SOUTH ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2207
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Country | US
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Telephone | 732-308-1652
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Fax | 732-308-1662
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Provider Business Mailing Address
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Address Line | 31B SOUTH ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2207
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Country | US
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Telephone | 732-308-1652
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Fax | 732-308-1662
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Authorized Official
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Title or Position | OWNER
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Name | DR. SNEHAL M. PATEL
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Credential | D.M.D.
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Telephone | 732-308-1652
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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 | 22DI02305200
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License Number State | NJ
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