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General NPI Number Information
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NPI Number | 1417005562
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Entity Type | Organization
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Legal Business Name | ASHOK K PATEL DMD PC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 SOUTH ST SUITE 100
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City | WALTHAM
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State | MA
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Zip | 02453-3594
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Country | US
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Telephone | 781-894-0500
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Fax | 781-894-1116
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Provider Business Mailing Address
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Address Line | 32 SOUTH ST SUITE 100
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City | WALTHAM
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State | MA
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Zip | 02453-3594
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Country | US
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Telephone | 781-894-0500
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Fax | 781-894-1116
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | DR. ASHOK K PATEL
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Credential | MDS, DMD
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Telephone | 781-894-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 17070
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License Number State | MA
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