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General NPI Number Information
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NPI Number | 1699407197
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Entity Type | Individual
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Provider Name | PRATEEK PATEL
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Gender | Male
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 2400 COMPUTER DR
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1887
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Country | US
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Telephone | 508-210-2257
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Fax |
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Provider Business Mailing Address
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Address Line | 400 LANGLEY RD UNIT 106
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City | NEWTON CENTER
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State | MA
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Zip | 02459-2394
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Country | US
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Telephone | 917-370-6984
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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 | 13013
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1860021
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License Number State | MA
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