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General NPI Number Information
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NPI Number | 1922591619
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Entity Type | Individual
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Provider Name | PRATIK S PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 1350 SW 160TH AVE
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City | SUNRISE
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State | FL
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Zip | 33326-1908
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Country | US
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Telephone | 954-385-9240
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Fax | 954-385-9260
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Provider Business Mailing Address
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Address Line | 11808 NW 2ND ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8020
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Country | US
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Telephone | 732-910-7949
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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 | DN23440
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License Number State | FL
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