Provider Demographics
NPI:1134589849
Name:HETAL AMIN-PATEL, D.D.S., P.L.L.C.
Entity type:Organization
Organization Name:HETAL AMIN-PATEL, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:AJIT
Authorized Official - Last Name:AMIN-PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-633-2612
Mailing Address - Street 1:1401 W INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2574
Mailing Address - Country:US
Mailing Address - Phone:704-633-2612
Mailing Address - Fax:
Practice Address - Street 1:1401 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2574
Practice Address - Country:US
Practice Address - Phone:704-633-2612
Practice Address - Fax:704-314-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7099 NC261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental