Individual
KETAN PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
342 N MAIN ST, SUITE 110, ALPHARETTA, GA 30004-8376
(678) 762-1613
(678) 762-1689
Mailing address
342 N MAIN ST, SUITE 110, ALPHARETTA, GA 30004-8376
(678) 762-1613
(678) 762-1689
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012835
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500129458B
—
GA
Enumeration date
08/15/2006
Last updated
07/08/2007
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