Provider Demographics
NPI:1174680631
Name:PATEL, SWARUPA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SWARUPA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 VAN HOUTEN AVE
Mailing Address - Street 2:2ND FLOOR, SUITE -1
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2068
Mailing Address - Country:US
Mailing Address - Phone:973-815-0600
Mailing Address - Fax:973-815-0212
Practice Address - Street 1:729 VAN HOUTEN AVE
Practice Address - Street 2:2ND FLOOR, SUITE -1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2068
Practice Address - Country:US
Practice Address - Phone:973-815-0600
Practice Address - Fax:973-815-0212
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0190801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice