Individual
DR. SHIVAM MUKUL PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
253 TALMADGE RD, EDISON, NJ 08817-2833
(732) 692-3980
Mailing address
10 FOLEY AVE, EDISON, NJ 08820-1927
(732) 692-3980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02843400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2020
Last updated
08/19/2021
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