Provider Demographics
NPI:1053416016
Name:PATEL, BHAVITA (DMD)
Entity type:Individual
Prefix:
First Name:BHAVITA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 PREMIER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7017
Mailing Address - Country:US
Mailing Address - Phone:972-423-0880
Mailing Address - Fax:972-423-3404
Practice Address - Street 1:3325 PREMIER DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7017
Practice Address - Country:US
Practice Address - Phone:972-423-0880
Practice Address - Fax:972-423-3404
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice