Individual
MITUL V PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1564 W LANE RD, MACHESNEY PARK, IL 61115-1903
(815) 637-6309
Mailing address
281 SANDERS CREEK PKWY, EAST SYRACUSE, NY 13057-1307
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28728
IL
Other
Enumeration date
07/06/2011
Last updated
11/01/2017
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