Provider Demographics
NPI:1568569374
Name:PATEL, BHASKERBHAI VITTHALBHAI (BDS)
Entity Type:Individual
Prefix:DR
First Name:BHASKERBHAI
Middle Name:VITTHALBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PITTSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3231
Mailing Address - Country:US
Mailing Address - Phone:570-346-7671
Mailing Address - Fax:
Practice Address - Street 1:1901 PITTSTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-3231
Practice Address - Country:US
Practice Address - Phone:570-346-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019580L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice