Provider Demographics
NPI:1295188993
Name:PATEL, BHARGAV M (DMD)
Entity Type:Individual
Prefix:DR
First Name:BHARGAV
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8913 WOODYARD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4257
Mailing Address - Country:US
Mailing Address - Phone:301-660-4187
Mailing Address - Fax:
Practice Address - Street 1:8913 WOODYARD RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4257
Practice Address - Country:US
Practice Address - Phone:301-660-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist