MEDICARE: DEEPTI PATIL 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	122300000X	Dentist	00203049	CO

General Provider Information

NPI Number	:	1760920235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEEPTI PATIL DDS

Provider Business Mailing Address
First Line	:	9201 E MISSISSIPPI AVE
Second Line	:	APT V-103
City	:	DENVER
State	:	CO
Zip	:	80247-6832
Country	:	US
Telephone Number	:	623-313-5278
Fax Number	:

Provider Business Practice Location Address
First Line	:	9201 E MISSISSIPPI AVE
Second Line	:	APT V-103
City	:	DENVER
State	:	CO
Zip	:	80247-6832
Country	:	US
Telephone Number	:	623-313-5278
Fax Number	:

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

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	02/06/2017

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