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General NPI Number Information
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NPI Number | 1548747082
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Entity Type | Organization
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Legal Business Name | GILL AND PATEL DENTAL CORPORATION
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 2610 REYNOLDS RANCH PKWY STE 100
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City | LODI
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State | CA
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Zip | 95240
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Country | US
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Telephone | 707-302-0805
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Fax | 707-302-0805
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Provider Business Mailing Address
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Address Line | 17000 RED HILL AVE
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City | IRVINE
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State | CA
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Zip | 92614-5626
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Country | US
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Telephone | 714-845-8500
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Fax | 949-474-1495
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Authorized Official
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Title or Position | OWNER
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Name | AMARDEEP K GILL
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Credential | DDS
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Telephone | 707-302-0805
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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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