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General NPI Number Information
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NPI Number | 1720030364
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Entity Type | Organization
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Legal Business Name | JAYSHREE A. PATEL DDS PA
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 5310 TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8049
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Country | US
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Telephone | 904-771-0933
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Fax | 904-771-0907
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Provider Business Mailing Address
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Address Line | 5310 TIMUQUANA RD
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City | JACKSONVILLE
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State | FL
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Zip | 32210-8049
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Country | US
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Telephone | 904-771-0933
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Fax | 904-771-0907
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAYSHREE ASHWIN PATEL
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Credential | DDS
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Telephone | 904-771-0933
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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 | DN0009954
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License Number State | FL
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