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Organization
JAYSHREE N. SHAH DDS, INC.
Active
Organization
JAYSHREE N. SHAH DDS, INC.
Active
Other names
Vivid Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
TEJAS SHAH (SECRETARY)
(714) 871-4892
Entity
Organization
Contact information
Practice address
301 W BASTANCHURY RD STE 5, FULLERTON, CA 92835-3422
(714) 871-4892
(714) 871-4896
Mailing address
301 W BASTANCHURY RD STE 5, FULLERTON, CA 92835-3422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34900
CA
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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