Individual
VIDISHA N PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
240 GEIGER RD, PHILADELPHIA, PA 19115-1008
(215) 677-0380
Mailing address
240 GEIGER RD, PHILADELPHIA, PA 19115-1008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS040062
PA
1223P0221X
Pediatric Dentistry
22DI02600900
NJ
1223P0221X
Pediatric Dentistry
Primary
DS040062
PA
Other
Enumeration date
04/10/2013
Last updated
07/05/2017
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