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Provider Information for 1467674309



DR. ADITI SHAH DDS

Gender: FEMALE

Individual NPI: 1467674309

Calendar Last Updated: 2016-04-15

Details

Name Value
NPI 1467674309
Enumeration Date 2007-05-02
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 5611 COLLEYVILLE BLVD SUITE 140
COLLEYVILLE, TX 76034-6069
United States

Phone: 817-809-4445 | Fax: 817-541-4449
View Map External Link
Primary Practice Address 5611 COLLEYVILLE BLVD SUITE 140
COLLEYVILLE, TX 76034-6069
United States

Phone: 817-809-4445 | Fax: 817-541-4449
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 22919