Individual
DR. MITSU PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 BROADWAY ST STE C, MOUNT VERNON, IL 62864-2282
(618) 241-0353
Mailing address
1380 MIDVALE AVE, LOS ANGELES, CA 90024-6269
(626) 780-9093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.036357
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2025
Last updated
07/29/2025
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