Provider Demographics
NPI:1194978643
Name:PATEL, AMBER DAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DAWN
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 1:5250 BLANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7017
Mailing Address - Country:US
Mailing Address - Phone:210-349-3368
Mailing Address - Fax:210-349-2473
Practice Address - Street 1:5250 BLANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7017
Practice Address - Country:US
Practice Address - Phone:210-349-3368
Practice Address - Fax:210-349-2473
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice