Provider Demographics
NPI:1770624876
Name:PATEL, CHATTAN MAGANBHAI (DDS)
Entity type:Individual
Prefix:DR
First Name:CHATTAN
Middle Name:MAGANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 CHURCH ST APT W205
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8016
Mailing Address - Country:US
Mailing Address - Phone:909-948-2745
Mailing Address - Fax:909-948-2745
Practice Address - Street 1:652 E. LAUREL DR.
Practice Address - Street 2:SUITE C
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-775-0280
Practice Address - Fax:831-775-0279
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist