Provider Demographics
NPI:1790806883
Name:PATEL, JAGAT N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAGAT
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GLEN HILL RD
Mailing Address - Street 2:SUIT #1
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4906
Mailing Address - Country:US
Mailing Address - Phone:203-778-3384
Mailing Address - Fax:203-778-4478
Practice Address - Street 1:2 GLEN HILL RD
Practice Address - Street 2:SUIT #1
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4906
Practice Address - Country:US
Practice Address - Phone:203-778-3384
Practice Address - Fax:203-778-4478
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0075661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice