Individual
DR. JAY BHAGAVANDAS PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 367-7146
Mailing address
4350 DOUTHART PL, MISHAWAKA, IN 46544-9188
(517) 402-9557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014074A
IN
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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