MEDICARE: COVE HOLDINGS LLC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	28609	TX

General Provider Information

NPI Number	:	1689035529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVE HOLDINGS LLC

Provider Business Mailing Address
First Line	:	4020 HEDGCOXE RD
Second Line	:	SUITE 400
City	:	PLANO
State	:	TX
Zip	:	75024-7700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 HEDGCOXE RD
Second Line	:	SUITE 400
City	:	PLANO
State	:	TX
Zip	:	75024-7700
Country	:	US
Telephone Number	:	972-618-1492
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. NIMESH PATEL
Credential	:	DMD
Telephone Number	:	614-975-4592

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	03/18/2016

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