Individual
DR. SAMIR DILIP PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2526 HIGHWAY 160 W STE 104, TEGA CAY, SC 29708-8487
(803) 650-3712
Mailing address
2526 HIGHWAY 160 W STE 104, TEGA CAY, SC 29708-8487
(803) 650-3712
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
10337
NC
1223P0300X
Periodontics
Primary
8229
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10337
DENTAL LICENSE
NC
01
—
8229
DENTAL LICENSE
SC
Enumeration date
03/07/2016
Last updated
06/18/2024
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