Organization
SUKET PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETANKUMAR G PATEL DMD (DENTIST)
(770) 931-1333
Entity
Organization
Contact information
Practice address
1235 INDIAN TRAIL RD, NORCROSS, GA 30093-4502
(770) 931-1333
Mailing address
1235 INDIAN TRAIL RD, NORCROSS, GA 30093-4502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012835
GA
1223P0221X
Pediatric Dentistry
DN012835
GA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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