Individual
ANITA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 W HANOVER AVE STE 105, RANDOLPH, NJ 07869-4221
(973) 598-3450
Mailing address
10 W HANOVER AVE STE 105, RANDOLPH, NJ 07869-4221
(973) 598-3450
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1858754
MA
1223E0200X
Endodontics
Primary
22DI02871900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
08/10/2022
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