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General NPI Number Information
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NPI Number | 1316115140
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Entity Type | Organization
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Legal Business Name | DR SA PATEL PA
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 231 W MAIN ST.
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City | COTTONWOOD
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State | MN
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Zip | 56229-0318
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Country | US
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Telephone | 507-423-5411
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Fax |
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Provider Business Mailing Address
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Address Line | 231 W MAIN STREET PO BOX 317
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City | COTTONWOOD
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State | MN
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Zip | 56229-0318
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Country | US
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Telephone | 507-423-5411
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. S.A. PATEL
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Credential | DDS
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Telephone | 507-423-5411
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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 | D8395
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License Number State | MN
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