Provider Demographics
NPI:1457792020
Name:PATEL, KAMLESH MANUBHAI (DMD, FAGD)
Entity Type:Individual
Prefix:DR
First Name:KAMLESH
Middle Name:MANUBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1091 GENERAL KNOX RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1359
Mailing Address - Country:US
Mailing Address - Phone:215-493-9525
Mailing Address - Fax:215-493-9506
Practice Address - Street 1:1091 GENERAL KNOX RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1359
Practice Address - Country:US
Practice Address - Phone:215-493-9525
Practice Address - Fax:215-493-9506
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028183L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist