Provider Demographics
NPI:1376941682
Name:PATEL, KAMESHKUMAR (DDS)
Entity Type:Individual
Prefix:
First Name:KAMESHKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N 25 MILE AVE
Mailing Address - Street 2:SMILE ACCENT PLLC
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045
Mailing Address - Country:US
Mailing Address - Phone:732-318-5745
Mailing Address - Fax:
Practice Address - Street 1:701 N 25 MILE AVE
Practice Address - Street 2:SMILE ACCENT PLLC
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045
Practice Address - Country:US
Practice Address - Phone:732-318-5745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice