Provider Demographics
NPI:1912003070
Name:PATLA, SAPNA (DDS)
Entity Type:Individual
Prefix:
First Name:SAPNA
Middle Name:
Last Name:PATLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 N BEERS ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1517
Mailing Address - Country:US
Mailing Address - Phone:732-335-5885
Mailing Address - Fax:908-686-2331
Practice Address - Street 1:723 N BEERS ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1517
Practice Address - Country:US
Practice Address - Phone:732-335-5885
Practice Address - Fax:908-686-2331
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD1022354001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics