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NPI Code Detail

MEDICARE: DR. SRUJALKUMAR PATEL D.D.S.

MEDICARE: DR. SRUJALKUMAR PATEL D.D.S.
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
1122300000XDentist2901020843MI

General Provider Information

NPI Number : 1760842652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SRUJALKUMAR PATEL D.D.S.
Provider Business Mailing Address
First Line : 2501 W PIERSON ROAD
Second Line : DENTAL DREAMS
City : FLINT
State : MI
Zip : 48504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2501 W PIERSON RD
Second Line : DENTAL DREAMS
City : FLINT
State : MI
Zip : 48504-6802
Country : US
Telephone Number : 310-890-9334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2016
Last Update Date : 03/06/2017

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