Provider Demographics
NPI:1912365354
Name:PATEL, SWATI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SWATI
Middle Name:
Last Name:PATEL
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 1:2909 GRAND WAY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0440
Mailing Address - Country:US
Mailing Address - Phone:318-773-7990
Mailing Address - Fax:
Practice Address - Street 1:411 BEN HUR RD STE G
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-5216
Practice Address - Country:US
Practice Address - Phone:225-960-6447
Practice Address - Fax:225-960-6457
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-31
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist