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General NPI Number Information
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NPI Number | 1215793286
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Entity Type | Organization
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Legal Business Name | DEVANG PATEL PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 301 N PEPPER AVE STE 200
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City | COLTON
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State | CA
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Zip | 92324-1839
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Country | US
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Telephone | 909-533-4138
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Fax | 909-533-4158
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Provider Business Mailing Address
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Address Line | 301 N PEPPER AVE STE 200
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City | COLTON
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State | CA
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Zip | 92324-1839
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Country | US
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Telephone | 909-533-4138
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Fax | 909-533-4158
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Authorized Official
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Title or Position | OWNER,PRESIDENT
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Name | DEVANGKUMAR J PATEL
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Credential | DDS
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Telephone | 909-856-6224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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