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General NPI Number Information
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NPI Number | 1275133811
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Entity Type | Organization
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Legal Business Name | 4K FAMILY DENTAL
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 12109 CENTENNIAL STA
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City | WARMINSTER
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State | PA
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Zip | 18974-5488
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Country | US
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Telephone | 215-443-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 1373 MEMORIAL DR
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City | WARWICK
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State | PA
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Zip | 18974-6136
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Country | US
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Telephone | 215-756-6021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEVESH P PATEL
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Credential | DMD
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Telephone | 215-900-0576
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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