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General NPI Number Information
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NPI Number | 1235522103
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Entity Type | Organization
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Legal Business Name | JAYRAJ J. PATEL D.M.D P.L.L.C
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 50 CYPRESS POINT PKWY STE A3
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City | PALM COAST
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State | FL
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Zip | 32164-2501
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Country | US
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Telephone | 386-445-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 5881 PEARL ESTATES LN
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City | SANFORD
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State | FL
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Zip | 32771-8520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | JAYRAJ J PATEL
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Credential | D.M.D.
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Telephone | 813-842-5837
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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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