MEDICARE: DR. MANOJ K PATEL 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	1223G0001X	General Practice Dentistry	DN-18982	FL

General Provider Information

NPI Number	:	1881919926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANOJ K PATEL DDS

Provider Business Mailing Address
First Line	:	2869 WILSHIRE DR STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3282
Country	:	US
Telephone Number	:	407-291-7220
Fax Number	:	407-291-7221

Provider Business Practice Location Address
First Line	:	2869 WILSHIRE DR STE 101
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3282
Country	:	US
Telephone Number	:	407-291-7220
Fax Number	:	407-291-7221

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

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	01/17/2013

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