Individual
DR. KETAN PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
176 THOMAS JOHNSON DR STE 200, FREDERICK, MD 21702-4532
(301) 264-7094
Mailing address
7115 FISH HATCHERY RD, FREDERICK, MD 21701-1716
(757) 237-5450
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416146
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401416146
DENTAL LICENSE
VA
01
—
18442
DENTAL LICENSE
MD
Enumeration date
07/02/2018
Last updated
05/05/2025
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