Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN011772 | GA |
NPI | 1073554630 |
---|---|
Provider Name | Piyushkimar P Patel |
First Address | Dunwoody, GA 30338-4103 |
Second Address | Dunwoody, GA 30338-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 10/02/2010 |