Provider Demographics
NPI:1558543330
Name:ANISH N PATEL DMD PA
Entity Type:Organization
Organization Name:ANISH N PATEL DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-841-2227
Mailing Address - Street 1:10550 INDEPENDENCE POINTE PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2690
Mailing Address - Country:US
Mailing Address - Phone:704-841-2227
Mailing Address - Fax:
Practice Address - Street 1:10550 INDEPENDENCE POINTE PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2690
Practice Address - Country:US
Practice Address - Phone:704-841-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty