Provider Demographics
NPI:1386966729
Name:MARKETPLACE DENTAL PC
Entity type:Organization
Organization Name:MARKETPLACE DENTAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-556-0600
Mailing Address - Street 1:2240 MARKET PLACE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8075
Mailing Address - Country:US
Mailing Address - Phone:972-556-0600
Mailing Address - Fax:
Practice Address - Street 1:2240 MARKET PLACE BLVD
Practice Address - Street 2:STE. 140
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-8072
Practice Address - Country:US
Practice Address - Phone:972-556-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty