Provider Demographics
NPI:1598053126
Name:PATEL, DHAGASH B (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DHAGASH
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 DANIEL SHAYS HWY APT B1
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9330
Mailing Address - Country:US
Mailing Address - Phone:617-416-9512
Mailing Address - Fax:
Practice Address - Street 1:333 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3940
Practice Address - Country:US
Practice Address - Phone:603-522-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04936122300000X
CT010682122300000X
PADS038961122300000X
MADN1855892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist