Provider Demographics
NPI:1437256690
Name:PATEL, KISHOR B (DDS)
Entity Type:Individual
Prefix:DR
First Name:KISHOR
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2757 ISLAND POINT DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-2536
Mailing Address - Country:US
Mailing Address - Phone:704-795-1515
Mailing Address - Fax:704-795-1516
Practice Address - Street 1:5303 POPLAR TENT RD
Practice Address - Street 2:SUITE 240
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9720
Practice Address - Country:US
Practice Address - Phone:704-795-1515
Practice Address - Fax:704-795-1516
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC73131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice