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General NPI Number Information
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NPI Number | 1447483219
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Entity Type | Individual
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Provider Name | KRUTAV PATEL DDS
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Gender | Male
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 326 N INDIAN HILL BLVD
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City | CLAREMONT
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State | CA
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Zip | 91711-4611
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Country | US
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Telephone | 909-626-1684
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Fax |
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Provider Business Mailing Address
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Address Line | 2879 WATER COURSE DR
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3657
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Country | US
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Telephone | 909-860-2448
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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 | 58701
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License Number State | CA
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