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General NPI Number Information
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NPI Number | 1396005203
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Entity Type | Individual
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Provider Name | DR. RICKEN PATEL
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Gender | Male
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 63 KRESSON RD SUITE 102
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City | CHERRY HILL
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State | NJ
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Zip | 08034-3200
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Country | US
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Telephone | 856-857-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 196 OLD BEEKMAN RD
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City | MONMOUTH JUNCTION
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State | NJ
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Zip | 08852-3117
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Country | US
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Telephone | 732-213-0036
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02496800
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License Number State | NJ
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