Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 010050 | CT |
NPI | 1023116829 |
---|---|
Provider Name | Dr. Avani Patel |
First Address | Stamford, CT 06901-3100 |
Second Address | Rochester, NY 14620-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 25/01/2010 |