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General NPI Number Information
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NPI Number | 1538709076
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Entity Type | Organization
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Legal Business Name | NEXGEN DENTAL LLC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 50 CYPRESS POINT PKWY STE A3
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City | PALM COAST
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State | FL
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Zip | 32164-2501
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Country | US
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Telephone | 732-910-7949
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Fax |
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Provider Business Mailing Address
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Address Line | 11808 NW 2ND ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8020
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Country | US
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Telephone | 732-910-7949
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. PRATIK S PATEL
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Credential | DMD
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Telephone | 732-910-7949
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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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