Provider Demographics
NPI:1538502976
Name:MANOJ K PATEL, DDS, PLLC
Entity Type:Organization
Organization Name:MANOJ K PATEL, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-949-9080
Mailing Address - Street 1:2869 WILSHIRE DR
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3282
Mailing Address - Country:US
Mailing Address - Phone:407-291-7220
Mailing Address - Fax:407-291-7221
Practice Address - Street 1:2869 WILSHIRE DR
Practice Address - Street 2:SUITE # 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3282
Practice Address - Country:US
Practice Address - Phone:407-291-7220
Practice Address - Fax:407-291-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental