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Organization
IMAGE DENTAL GROUP
Active
Organization
IMAGE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT RAMAN PATEL DDS (OWNER)
(619) 469-4144
Entity
Organization
Contact information
Practice address
7557 EL CAJON BLVD, SUITE A, LA MESA, CA 91942-7823
(619) 469-4144
(619) 469-4143
Mailing address
7557 EL CAJON BLVD, SUITE A, LA MESA, CA 91942-7823
(619) 469-4144
(619) 469-4142
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51847
CA
Other
Enumeration date
04/14/2008
Last updated
08/30/2012
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