Provider Demographics
NPI:1982051843
Name:PATEL, BHAVYA (DMD)
Entity type:Individual
Prefix:
First Name:BHAVYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LAFAYETTE RD UNIT 205
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4596
Mailing Address - Country:US
Mailing Address - Phone:603-814-1640
Mailing Address - Fax:
Practice Address - Street 1:380 LAFAYETTE RD UNIT 205
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4596
Practice Address - Country:US
Practice Address - Phone:603-814-1640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist