# PRAMUKHASHISH, LLC

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

## Provider details

- **NPI number:** 1518024413
- **Authorized official:** DR. KAVITA PANKAJ PATEL D.D.S. (SINGLE-MEMBER OWNER)
- **Authorized official phone:** (732) 382-4104

## Contact information

- **Practice address:** 1503 SAINT GEORGES AVE, SUITE 102, COLONIA, NJ 07067-3425
- **Practice address phone:** (732) 382-4104
- **Practice address fax:** (732) 388-6078
- **Mailing address:** 1503 SAINT GEORGES AVE, SUITE 102, COLONIA, NJ 07067-3425
- **Mailing address phone:** (732) 382-4104
- **Mailing address fax:** (732) 388-6078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI02033900 | NJ | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 08/22/2020