MEDICARE: KA DENTAL GROUP WPB, PA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1457848871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KA DENTAL GROUP WPB, PA

Provider Business Mailing Address
First Line	:	1962 S MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-6406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1962 S MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-6406
Country	:	US
Telephone Number	:	973-767-3283
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRUNAL PATEL
Credential	:	DDS
Telephone Number	:	973-767-3283

Provider Enumeration Date	:	04/20/2018
Last Update Date	:	01/28/2025

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