# PENN VALLEY DENTAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023406220
- **Authorized official:** DR. RAHOOL PATEL (OWNER)
- **Authorized official phone:** (732) 735-5337

## Contact information

- **Practice address:** 408 N KEYSTONE AVE, SAYRE, PA 18840-1825
- **Practice address phone:** (570) 888-5811
- **Practice address fax:** (570) 888-5607
- **Mailing address:** 408 N KEYSTONE AVE, SAYRE, PA 18840-1825
- **Mailing address phone:** (570) 888-5811
- **Mailing address fax:** (570) 888-5607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS036085 | PA | Yes |

## Other

- **Enumeration date:** 12/23/2014
- **Last updated:** 12/23/2014