Individual
TINA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11501 S 4000 W STE 101, SOUTH JORDAN, UT 84009
(017) 012-1208
Mailing address
1821 W CAPITOL AVE, WEST SACRAMENTO, CA 95691-2521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10635042-9921
UT
Other
Enumeration date
03/10/2017
Last updated
07/17/2018
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