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General NPI Number Information
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NPI Number | 1306006739
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Entity Type | Individual
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Provider Name | AMIT BABUBHAI PATEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 20600 GORDON PARK SQ SUITE 110
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City | ASHBURN
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State | VA
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Zip | 20147-3145
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Country | US
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Telephone | 703-724-4470
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Fax |
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Provider Business Mailing Address
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Address Line | 20600 GORDON PARK SQ SUITE 110
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City | ASHBURN
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State | VA
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Zip | 20147-3145
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Country | US
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Telephone | 703-724-4470
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401412145
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License Number State | VA
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