Provider Demographics
NPI:1972958635
Name:MEENAL H PATEL DMD PLLC
Entity Type:Organization
Organization Name:MEENAL H PATEL DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:DR
Authorized Official - First Name:MEENAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-678-1453
Mailing Address - Street 1:513 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5321
Mailing Address - Country:US
Mailing Address - Phone:352-678-1453
Mailing Address - Fax:
Practice Address - Street 1:513 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5321
Practice Address - Country:US
Practice Address - Phone:352-678-1453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty