MEDICARE: TORAL PANKAJ PATEL DMD

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	DS044820	PA

General Provider Information

NPI Number	:	1689402257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORAL PANKAJ PATEL DMD

Provider Business Mailing Address
First Line	:	6501 E SIERRA MORENA ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85215-7708
Country	:	US
Telephone Number	:	602-421-9618
Fax Number	:

Provider Business Practice Location Address
First Line	:	7052 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19135-1617
Country	:	US
Telephone Number	:	267-351-8089
Fax Number	:

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

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	07/25/2024

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