Provider Demographics
NPI:1447421839
Name:DEVANG PATEL DDS INC
Entity Type:Organization
Organization Name:DEVANG PATEL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVANG
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-824-7060
Mailing Address - Street 1:895 W VALLEY BLVD
Mailing Address - Street 2:SUIT#C
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-2000
Mailing Address - Country:US
Mailing Address - Phone:909-824-7060
Mailing Address - Fax:909-824-7066
Practice Address - Street 1:895 W VALLEY BLVD
Practice Address - Street 2:SUIT#C
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-2000
Practice Address - Country:US
Practice Address - Phone:909-824-7060
Practice Address - Fax:909-824-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty