Provider Demographics
NPI:1861273112
Name:PURAV B PATEL, DDS, PLLC
Entity type:Organization
Organization Name:PURAV B PATEL, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PURAV
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:682-557-6205
Mailing Address - Street 1:401 STAGE LINE DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-3967
Mailing Address - Country:US
Mailing Address - Phone:682-557-6205
Mailing Address - Fax:
Practice Address - Street 1:420 E ROUND GROVE RD STE 640
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8138
Practice Address - Country:US
Practice Address - Phone:682-557-6205
Practice Address - Fax:682-557-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental