Fairview Dental LLC

NPI #1891280673 in Ellenwood, Georgia

Provider Information

NPI Number: 1891280673
Entity Type: Organization
Organization Name: Fairview Dental LLC
Subpart: Yes (part of a larger organization)
Parent Organization: AMTECH DENTAL LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jun 25, 2018
Last Updated: Jun 25, 2018

Practice Location

Address: 210 FAIRVIEW RD
City: Ellenwood
State: Georgia
ZIP Code: 30294-2704
Phone: (281) 728-5042

Authorized Official

Name: AMI PATEL, DDS
Title: DENTIST
Phone: (281) 728-5042

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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