Individual
DR. RAVI KUMAR VIJAY PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6091 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 763-8112
(219) 764-5356
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019029457
IL
122300000X
Dentist
Primary
12012016A
IN
Other
Enumeration date
06/21/2013
Last updated
02/12/2014
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