Organization
MANISHA DESAI PATEL
Active
Other names
Lake Norman Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MANISHA D PATEL DDS (OWNER)
(704) 799-0552
Entity
Organization
Contact information
Practice address
224 TALBERT RD, MOORESVILLE, NC 28117-9124
(704) 799-0552
(704) 749-8653
Mailing address
224 TALBERT RD, MOORESVILLE, NC 28117-9124
(704) 799-0552
(704) 749-8653
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6771
NC
1223G0001X
General Practice Dentistry
Primary
6332
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899008A
—
NC
05
—
899008C
—
NC
Enumeration date
02/12/2009
Last updated
02/12/2009
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