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General NPI Number Information
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NPI Number | 1457525271
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Entity Type | Organization
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Legal Business Name | SRP DENTAL CARE, P.C.
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 48 E KINGSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10468-7514
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Country | US
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Telephone | 718-933-9603
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Fax | 718-866-0337
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Provider Business Mailing Address
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Address Line | 250 W CLARKSTOWN RD
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City | NEW CITY
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State | NY
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Zip | 10956-7221
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Country | US
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Telephone | 718-933-9603
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Fax | 718-866-0337
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. SURENDRA R PATEL
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Credential | DDS
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Telephone | 718-933-9603
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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 |
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License Number State |
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