Provider Demographics
NPI:1831485416
Name:PATEL, RUPAL SUKUMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:SUKUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 BRITTANY FARMS RD
Mailing Address - Street 2:#128
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1100
Mailing Address - Country:US
Mailing Address - Phone:317-414-5195
Mailing Address - Fax:
Practice Address - Street 1:19 WOODLAND ST
Practice Address - Street 2:SUITE 32
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2372
Practice Address - Country:US
Practice Address - Phone:860-525-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10832122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist