Provider Demographics
NPI:1447560966
Name:PATEL, AMIT MAHESH (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:MAHESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 MCKINNEY AVE
Mailing Address - Street 2:#186
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2016
Mailing Address - Country:US
Mailing Address - Phone:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260531223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics