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General NPI Number Information
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NPI Number | 1477736858
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Entity Type | Individual
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Provider Name | GAYATRI PATEL D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/09/2007
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 100 PORTER RD STE 105
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City | POTTSTOWN
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State | PA
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Zip | 19464
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Country | US
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Telephone | 610-327-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 100 PORTER RD STE 105
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City | POTTSTOWN
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State | PA
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Zip | 19464-3240
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Country | US
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Telephone | 610-327-1175
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401411913
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS037441
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License Number State | PA
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