Provider Demographics
NPI:1942465349
Name:PATEL, AMAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PRIMROSE LN
Mailing Address - Street 2:SUITE A/B
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1229
Mailing Address - Country:US
Mailing Address - Phone:717-285-3030
Mailing Address - Fax:717-285-2906
Practice Address - Street 1:313 PRIMROSE LN
Practice Address - Street 2:SUITE A/B
Practice Address - City:MOUNTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17554-1229
Practice Address - Country:US
Practice Address - Phone:717-285-3030
Practice Address - Fax:717-285-2906
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0374581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice