Provider Demographics
NPI:1710028816
Name:CHATTAN M. PATEL DDS INC.
Entity Type:Organization
Organization Name:CHATTAN M. PATEL DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHATTAN
Authorized Official - Middle Name:MAGANBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-948-2745
Mailing Address - Street 1:10850 CHURCH ST APT W205
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8016
Mailing Address - Country:US
Mailing Address - Phone:909-948-2745
Mailing Address - Fax:
Practice Address - Street 1:652 E. LAUREL DR.
Practice Address - Street 2:SUITE C
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-775-0280
Practice Address - Fax:831-775-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty