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Individual

DR. NISHA PATEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
200 E PONCE DE LEON AVE, DECATUR, GA 30030-3466
(256) 493-6886
Mailing address
PO BOX 264, TALLADEGA, AL 35161-0264

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
6050 C1
AL
122300000X
Dentist
Primary
DN014677
GA

Other

Enumeration date
09/05/2013
Last updated
12/09/2014
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