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General NPI Number Information
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NPI Number | 1891122248
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Entity Type | Organization
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Legal Business Name | NANCY R PATEL DDS INC.
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 1579 S SAN JACINTO AVE STE 1
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City | SAN JACINTO
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State | CA
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Zip | 92583-5107
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Country | US
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Telephone | 951-795-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92543-3953
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Country | US
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Telephone | 951-795-1216
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Fax | 951-766-7739
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Authorized Official
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Title or Position | OWNER
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Name | DR. NANCY R PATEL
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Credential | DDS
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Telephone | 951-795-1216
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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 | 56709
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License Number State | CA
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