Provider Demographics
NPI:1356488043
Name:PATEL, HARISH B (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARISH
Middle Name:B
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 1:27 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1883
Mailing Address - Country:US
Mailing Address - Phone:973-564-9211
Mailing Address - Fax:
Practice Address - Street 1:27 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1883
Practice Address - Country:US
Practice Address - Phone:973-564-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ194021223G0001X
PADS029422-L1223G0001X
NC83441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice