Provider Demographics
NPI:1740411966
Name:KAMLESH G. PATEL, D.M.D., P.A.
Entity Type:Organization
Organization Name:KAMLESH G. PATEL, D.M.D., P.A.
Other - Org Name:MAPLE LAWN ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMLESH
Authorized Official - Middle Name:GORDHANBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-776-9500
Mailing Address - Street 1:7625 MAPLE LAWN BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2565
Mailing Address - Country:US
Mailing Address - Phone:301-776-9500
Mailing Address - Fax:
Practice Address - Street 1:7625 MAPLE LAWN BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:301-776-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty