MEDICARE: AMERICARE DENTAL P.A.

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	22DI02347800	NJ

General Provider Information

NPI Number	:	1780966317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICARE DENTAL P.A.

Provider Business Mailing Address
First Line	:	6418 BERGENLINE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1621
Country	:	US
Telephone Number	:	201-868-6400
Fax Number	:	201-868-6689

Provider Business Practice Location Address
First Line	:	6418 BERGENLINE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1621
Country	:	US
Telephone Number	:	201-868-6400
Fax Number	:	201-868-6689

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AMISH PATEL
Credential	:	DMD
Telephone Number	:	267-221-9898

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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