Provider Demographics
NPI:1134474364
Name:PATIL, MADHUR (DMD)
Entity type:Individual
Prefix:
First Name:MADHUR
Middle Name:
Last Name:PATIL
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4836 E TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3635
Mailing Address - Country:US
Mailing Address - Phone:717-737-5834
Mailing Address - Fax:717-737-2158
Practice Address - Street 1:4836 E TRINDLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3635
Practice Address - Country:US
Practice Address - Phone:717-737-5834
Practice Address - Fax:717-737-2158
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0392541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry