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General NPI Number Information
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NPI Number | 1225760010
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Entity Type | Individual
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Provider Name | ASHUTOSH DILIP PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 9335 BLAKENEY CENTRE DR STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28277-6665
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Country | US
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Telephone | 413-274-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 CEDRIC CT
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City | FORT MILL
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State | SC
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Zip | 29715-1101
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Country | US
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Telephone | 919-825-7219
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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 | 12805
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License Number State | NC
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