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General NPI Number Information
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NPI Number | 1427399815
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Entity Type | Organization
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Legal Business Name | KA DENTAL GROUP PA
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 9810 ALTERNATE A1A STE- 106
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4932
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Country | US
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Telephone | 561-624-7988
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Fax |
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Provider Business Mailing Address
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Address Line | 9810 ALTERNATE A1A STE- 106
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | KRUNAL PATEL
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Credential |
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Telephone | 973-767-3283
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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 | 19875
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 19874
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License Number State | FL
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