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Organization
SUN SMILE DENTAL GROUP
Active
Organization
SUN SMILE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHISHIR NAVINCHANDRA SHAH DDS (PRESIDENT)
(760) 744-1300
Entity
Organization
Contact information
Practice address
1582 W SAN MARCOS BLVD, SUITE 201, SAN MARCOS, CA 92078-4081
(760) 744-1300
(760) 744-1342
Mailing address
1582 W SAN MARCOS BLVD, SUITE 201, SAN MARCOS, CA 92078-4081
(760) 744-1300
(760) 744-1342
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5402
CA
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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