Provider Demographics
NPI:1386890804
Name:DR.T.R.PATEL
Entity type:Organization
Organization Name:DR.T.R.PATEL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TULSIDAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-282-0042
Mailing Address - Street 1:502 B PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSONCITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-282-0042
Mailing Address - Fax:423-232-0042
Practice Address - Street 1:502 B PRINCETON RD
Practice Address - Street 2:
Practice Address - City:JOHNSONCITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-282-0042
Practice Address - Fax:423-232-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty