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General NPI Number Information
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NPI Number | 1770159378
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Entity Type | Individual
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Provider Name | PARAGKUMAR S PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 8294 HIGHWAY 92 STE 200
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City | WOODSTOCK
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State | GA
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Zip | 30189-3672
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Country | US
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Telephone | 678-737-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 514 HAMPTON XING
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City | WOODSTOCK
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State | GA
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Zip | 30188-1416
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Country | US
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Telephone | 404-702-2518
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019033106
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN123093
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License Number State | GA
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