Provider Demographics
NPI:1376925420
Name:AMIT M PATEL, DDS, MSD, PLLC
Entity Type:Organization
Organization Name:AMIT M PATEL, DDS, MSD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:972-242-7603
Mailing Address - Street 1:2440 N JOSEY LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1668
Mailing Address - Country:US
Mailing Address - Phone:972-242-7603
Mailing Address - Fax:
Practice Address - Street 1:2440 N JOSEY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1668
Practice Address - Country:US
Practice Address - Phone:972-242-7603
Practice Address - Fax:972-242-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26053261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental