Provider Demographics
NPI:1245687078
Name:PATEL, MONICA Y (DMD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 ROCKHILL LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-2939
Mailing Address - Country:US
Mailing Address - Phone:908-616-2025
Mailing Address - Fax:
Practice Address - Street 1:3428 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2610
Practice Address - Country:US
Practice Address - Phone:215-331-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02674800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No122300000XDental ProvidersDentist