# PATEL, KOSTELIC & ASSOCIATES, PLLC

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

## Provider details

- **NPI number:** 1104496470
- **Authorized official:** RAJIV PATEL DMD (OWNER/MANAGER)
- **Authorized official phone:** (704) 796-7397

## Contact information

- **Practice address:** 901 N WINSTEAD AVE STE 120, ROCKY MOUNT, NC 27804-8712
- **Practice address phone:** (704) 796-7397
- **Mailing address:** 2441 MOSS GROVE XING, WINSTON SALEM, NC 27103-6422
- **Mailing address phone:** (336) 577-1583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2021
- **Last updated:** 06/29/2021