Provider Demographics
NPI:1366559411
Name:PATEL, PRAMILA R (DDS)
Entity type:Individual
Prefix:MRS
First Name:PRAMILA
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NO FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117
Mailing Address - Country:US
Mailing Address - Phone:805-967-1197
Mailing Address - Fax:805-967-3090
Practice Address - Street 1:141 NO FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117
Practice Address - Country:US
Practice Address - Phone:805-967-1197
Practice Address - Fax:805-967-3090
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist