Provider Demographics
NPI:1790800241
Name:PATEL, RASHMIKANT R (BDS, MDSC)
Entity Type:Individual
Prefix:DR
First Name:RASHMIKANT
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:BDS, MDSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BLANDING BLVD 4
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-3342
Mailing Address - Country:US
Mailing Address - Phone:904-276-5143
Mailing Address - Fax:904-276-2737
Practice Address - Street 1:168 BLANDING BLVD
Practice Address - Street 2:SUITE 4 A-1 DENTAL CARE, INC.
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3371
Practice Address - Country:US
Practice Address - Phone:904-276-5143
Practice Address - Fax:904-276-2737
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN108671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL072384300Medicaid