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Individual

VIJAY PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 682-1087
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 818-3630

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008559
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
743747
AZ
Enumeration date
08/14/2012
Last updated
07/21/2015
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