Provider Demographics
NPI:1053421339
Name:PATEL, MUKESH UTTAM (DDS)
Entity type:Individual
Prefix:
First Name:MUKESH
Middle Name:UTTAM
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 W BUCKINGHAM RD
Mailing Address - Street 2:SUITE #340
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4934
Mailing Address - Country:US
Mailing Address - Phone:972-276-2451
Mailing Address - Fax:972-276-2451
Practice Address - Street 1:2334 W BUCKINGHAM RD
Practice Address - Street 2:SUITE #340
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4934
Practice Address - Country:US
Practice Address - Phone:972-276-2451
Practice Address - Fax:972-276-2451
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist