Provider Demographics
NPI:1245405042
Name:PATEL, JAY J (DMD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:5252 ROSWELL ROAD NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-907-2117
Mailing Address - Fax:404-907-2118
Practice Address - Street 1:5252 ROSWELL ROAD NE
Practice Address - Street 2:SUITE 201
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-907-2117
Practice Address - Fax:404-907-2118
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2013-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GADN0129301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery