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Provider Information for 1780995043

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. HETAL SUJAL PATEL D.D.S.

Gender: FEMALE

Individual NPI: 1780995043

Calendar   Last Updated:  2011-09-27
  Certification Date: 

Details

Name Value
NPI 1780995043
Enumeration Date 2010-07-01
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 44757 CHERRY HILL RD
CANTON, MI 48188-1071
United States

Phone: 248-668-9419 | Fax:
View Map External Link
Primary Practice Address 1080 E WEST MAPLE RD
WALLED LAKE, MI 48390-3571
United States

Phone: 248-668-9419 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist MI 2901020257
No 1223G0001X - Dentist General Practice MI 2901020257