Individual
NIKETA KRUNAL PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3196
(414) 771-2345
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001239-15
WI
Other
Enumeration date
07/13/2023
Last updated
08/29/2023
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