Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN014121 | GA |
NPI | 1003120544 |
---|---|
Provider Name | Maheshvar Patel |
First Address | Marietta, GA 30066-3360 |
Second Address | Atlanta, GA 30305-3425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2010 |
Last Update Date | 02/04/2019 |