Provider Demographics
NPI:1760213144
Name:PATEL, RUTVIK (DMD)
Entity type:Individual
Prefix:DR
First Name:RUTVIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9918 BRAWLEY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5004
Mailing Address - Country:US
Mailing Address - Phone:704-569-4996
Mailing Address - Fax:
Practice Address - Street 1:1900 WELLNESS BLVD # 104
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7763
Practice Address - Country:US
Practice Address - Phone:704-296-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist