Provider Demographics
NPI:1720007263
Name:PATEL, RAMAN K (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:120 S 15TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4500
Mailing Address - Country:US
Mailing Address - Phone:360-424-7921
Mailing Address - Fax:360-424-7922
Practice Address - Street 1:120 S 15TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4500
Practice Address - Country:US
Practice Address - Phone:360-424-7921
Practice Address - Fax:360-424-7922
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2021-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WADE000103691223G0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies