Individual
KOMAL S PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
28345 BECK RD, #409, WIXOM, MI 48393-4733
(888) 477-7325
Mailing address
2281 LAKE RIDGE DR, GRAND BLANC, MI 48439-7365
(919) 306-2870
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
055639
NY
122300000X
Dentist
Primary
2901021723
MI
122300000X
Dentist
DI02502600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2010
Last updated
11/24/2015
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