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General NPI Number Information
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NPI Number | 1740422641
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Entity Type | Organization
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Legal Business Name | SHITAL PATEL D.D.S. & RAKESH PATEL D.D.S., INC
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 160 E ONTARIO AVE SUITE #103
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City | CORONA
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State | CA
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Zip | 92879-3510
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Country | US
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Telephone | 951-898-8845
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Fax | 951-898-6985
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Provider Business Mailing Address
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Address Line | 160 E ONTARIO AVE SUITE #103
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City | CORONA
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State | CA
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Zip | 92879-3510
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Country | US
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Telephone | 951-898-8845
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Fax | 951-898-6985
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. RAKESH R PATEL
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Credential | D.D.S.
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Telephone | 951-898-8845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 44238
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License Number State | CA
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