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General NPI Number Information
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NPI Number | 1447421839
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Entity Type | Organization
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Legal Business Name | DEVANG PATEL DDS INC
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 895 W VALLEY BLVD SUIT#C
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City | COLTON
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State | CA
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Zip | 92324-2000
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Country | US
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Telephone | 909-824-7060
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Fax | 909-824-7066
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Provider Business Mailing Address
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Address Line | 895 W VALLEY BLVD SUIT#C
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City | COLTON
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State | CA
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Zip | 92324-2000
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Country | US
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Telephone | 909-824-7060
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Fax | 909-824-7066
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Authorized Official
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Title or Position | GENERAL DENTIST/PRESIDENT
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Name | DEVANG J PATEL
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Credential | DDS
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Telephone | 909-824-7060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49634
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License Number State | CA
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