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General NPI Number Information
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NPI Number | 1649916727
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Entity Type | Organization
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Legal Business Name | PATEL DENTAL PLLC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 201 W INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4313
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Country | US
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Telephone | 386-258-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4313
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Country | US
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Telephone | 386-316-9952
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | DR. DARSHAN PATEL
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Credential | DMD
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Telephone | 386-258-7500
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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 |
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License Number State |
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