MEDICARE: DR. ASHISH C PATEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	11620	GA

General Provider Information

NPI Number	:	1093828238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHISH C PATEL DDS

Provider Business Mailing Address
First Line	:	3535 ROSWELL RD STE 55
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-321-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 55
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-321-5558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	04/06/2021

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Directions to “ DR. ASHISH C PATEL DDS” Practice Location

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