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Individual

DHARA PATEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1812 BROADWAY ST, MELROSE PARK, IL 60160-2039
(312) 771-5380
Mailing address
930 OMAHA DR, NORCROSS, GA 30093-4964

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030821
IL

Other

Enumeration date
07/25/2016
Last updated
07/25/2016
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