Provider Demographics
NPI:1003921677
Name:PATEL, HARSHA J (DDS)
Entity Type:Individual
Prefix:MRS
First Name:HARSHA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1024 PARK AVENUE SUITE #7
Mailing Address - Street 2:PARK AVENUE GENTLE DENTAL C/O HARSHA J PATEL
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060
Mailing Address - Country:US
Mailing Address - Phone:908-756-1009
Mailing Address - Fax:
Practice Address - Street 1:1024 PARK AVENUE SUITE #7
Practice Address - Street 2:PARK AVENUE GENTLE DENTAL C/O HARSHA J PATEL
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060
Practice Address - Country:US
Practice Address - Phone:908-756-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI19358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7179707Medicaid