Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN09473 | FL |
NPI | 1003956921 |
---|---|
Provider Name | Dr. Bhasker C Patel |
First Address | Orange City, FL 32763-8209 |
Second Address | Orange City, FL 32763-8209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |