Organization
FAIRVIEW DENTAL LLC
Active
Parent organization
AMTECH DENTAL LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMTECH DENTAL LLC
Authorized official
AMI PATEL DDS (DENTIST)
(281) 728-5042
Entity
Organization
Contact information
Practice address
210 FAIRVIEW RD, ELLENWOOD, GA 30294-2704
(281) 728-5042
Mailing address
210 FAIRVIEW RD, ELLENWOOD, GA 30294-2704
(281) 728-5042
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN015055
GA
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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