Individual
DR. ROSHAN VIJAY PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
5700 EDWARDS RANCH RD STE 100, FORT WORTH, TX 76109-4128
(817) 292-2004
(817) 292-7083
Mailing address
5700 EDWARDS RANCH RD STE 100, FORT WORTH, TX 76109-4128
(817) 292-2004
(817) 292-7083
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0977
NC
122300000X
Dentist
20642
FL
1223G0001X
General Practice Dentistry
30.025952
OH
1223P0221X
Pediatric Dentistry
Primary
36187
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020110100
—
FL
Enumeration date
07/01/2014
Last updated
06/11/2021
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