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Organization
GAINESVILLE DENTAL CENTER
Active
Organization
GAINESVILLE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETANKUMAR G PATEL D.M.D. (DENTIST)
(770) 534-0697
Entity
Organization
Contact information
Practice address
1586 PARK HILL DR, GAINESVILLE, GA 30501-1950
(770) 534-0697
(770) 534-1724
Mailing address
1586 PARK HILL DR, GAINESVILLE, GA 30501-1950
(770) 534-0697
(770) 534-1724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN007359
GA
122300000X
Dentist
DN008017
GA
122300000X
Dentist
DN012835
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003142235A
—
GA
05
—
500129458D
—
GA
Enumeration date
03/28/2007
Last updated
01/12/2015
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