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DR. VIPUL ANANT PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
(860) 751-9195
Mailing address
553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
(860) 751-9195

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009785
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009-785
CT DENTAL LICENCE NUMBER
CT
05
02813156
NY
05
908002145
CT
Enumeration date
08/01/2007
Last updated
09/26/2012
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