Provider Demographics
NPI:1467569152
Name:PATEL, AMUL G (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMUL
Middle Name:G
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 1:22 SOUTH 1ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:MT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-668-3341
Mailing Address - Fax:914-668-1176
Practice Address - Street 1:22 SOUTH 1ST AVENUE
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-668-3341
Practice Address - Fax:914-668-1176
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0442621223G0001X
CT0104541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice