Individual
DR. TINA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E PONCE DE LEON AVE, DECATUR, GA 30030-3466
(678) 836-2113
Mailing address
325 E PACES FERRY RD NE, 1102, ATLANTA, GA 30305-5709
(404) 293-0564
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0024271
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN013835
GA
Other
Enumeration date
04/09/2009
Last updated
10/28/2010
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