# SHIV PATEL DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harbor Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215276746
- **Authorized official:** MS. JUDY A DOMINGUEZ (OFFICE MANAGER)
- **Authorized official phone:** (310) 835-3144

## Contact information

- **Practice address:** 25617 DODGE AVE, HARBOR CITY, CA 90710-3101
- **Practice address phone:** (310) 835-3144
- **Mailing address:** 25617 DODGE AVE, HARBOR CITY, CA 90710-3101
- **Mailing address phone:** (310) 835-3144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | CA49973 | CA | Yes |

## Other

- **Enumeration date:** 02/04/2013
- **Last updated:** 02/04/2013