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General NPI Number Information
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NPI Number | 1457243719
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Entity Type | Individual
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Provider Name | DHRUTIBEN KHODABHAI PATEL DDS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 12628 FREMONT AVE
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City | ZIMMERMAN
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State | MN
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Zip | 55398-9735
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Country | US
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Telephone | 833-217-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 9 WIND RIDGE RD
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City | SOUTH BARRINGTON
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State | IL
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Zip | 60010-5316
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Country | US
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Telephone | 929-525-5323
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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 | D15365
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License Number State | MN
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