Individual
KETU PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 W BANKHEAD HWY, VILLA RICA, GA 30180-1702
(770) 456-2550
Mailing address
127 AFFINITY LN APT C, BUFFALO, NY 14215-2446
(224) 388-1497
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN122752
GA
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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