Provider Demographics
NPI:1710468194
Name:PATEL, KESHAV ASHWIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KESHAV
Middle Name:ASHWIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 WINFIELD CT
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-3317
Mailing Address - Country:US
Mailing Address - Phone:609-598-0921
Mailing Address - Fax:
Practice Address - Street 1:327 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2222
Practice Address - Country:US
Practice Address - Phone:855-409-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist