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General NPI Number Information
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NPI Number | 1487111985
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Entity Type | Individual
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Provider Name | MITTAL ASHOKKUMAR PATEL DDS
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Gender | Female
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 2083 COMPTON AVE STE 102
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City | CORONA
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State | CA
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Zip | 92881-7288
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Country | US
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Telephone | 951-737-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 2747 SANTA FIORA DR
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City | CORONA
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State | CA
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Zip | 92882-1113
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Country | US
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Telephone | 978-394-5197
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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 | 103554
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License Number State | CA
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