MEDICARE: PRIYA SANTILAL 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	1223G0001X	General Practice Dentistry	DS041673	PA

General Provider Information

NPI Number	:	1194104604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIYA SANTILAL PATEL DDS

Provider Business Mailing Address
First Line	:	298 WISSAHICKON AVE STE 3
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-4156
Country	:	US
Telephone Number	:	828-508-6940
Fax Number	:

Provider Business Practice Location Address
First Line	:	298 WISSAHICKON AVE STE 3
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-4156
Country	:	US
Telephone Number	:	215-699-1009
Fax Number	:	215-699-1022

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

Provider Enumeration Date	:	05/29/2015
Last Update Date	:	12/05/2021

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