Individual
MRS. KHUSBU PRAVIN PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
6323 MEMORIAL HWY, TAMPA, FL 33615
(239) 658-3000
Mailing address
1773 W FLETCHER AVE., TAMPA, FL 33612
(941) 445-7926
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN23297
FL
1223P0221X
Pediatric Dentistry
DN23297
FL
Other
Enumeration date
04/17/2016
Last updated
12/13/2019
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