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General NPI Number Information
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NPI Number | 1326936469
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Entity Type | Organization
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Legal Business Name | PAVAN PUTRA SA
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 319 REDMOND RD NW
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City | ROME
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State | GA
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Zip | 30165-1539
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Country | US
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Telephone | 706-622-2985
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Fax |
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Provider Business Mailing Address
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Address Line | 2788 STONE HALL DR
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City | MARIETTA
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State | GA
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Zip | 30062-5061
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Country | US
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Telephone | 770-815-0194
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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. SAAHIL ANIL PATEL
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Credential | DMD
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Telephone | 770-815-0194
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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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