Provider Demographics
NPI:1598929408
Name:PATEL, MAYUR MAHENDRA (DDS, MS)
Entity Type:Individual
Prefix:
First Name:MAYUR
Middle Name:MAHENDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 JOHNNIE DODDS BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3028
Mailing Address - Country:US
Mailing Address - Phone:843-849-9044
Mailing Address - Fax:
Practice Address - Street 1:682 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3028
Practice Address - Country:US
Practice Address - Phone:843-849-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC40121223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics