Provider Demographics
NPI:1194104604
Name:PATEL, PRIYA SANTILAL (DDS)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:SANTILAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 WISSAHICKON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-4156
Mailing Address - Country:US
Mailing Address - Phone:828-508-6940
Mailing Address - Fax:
Practice Address - Street 1:298 WISSAHICKON AVE STE 3
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-4156
Practice Address - Country:US
Practice Address - Phone:215-699-1009
Practice Address - Fax:215-699-1022
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0416731223G0001X
NC1000671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice