# MK SHAH DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MY DENTAVILLE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881463172
- **Authorized official:** MANSI SHAH DMD (DENTIST)
- **Authorized official phone:** (336) 249-2906

## Contact information

- **Practice address:** 227 N TALBERT BLVD, LEXINGTON, NC 27292-4142
- **Practice address phone:** (336) 249-2906
- **Mailing address:** 227 N TALBERT BLVD, LEXINGTON, NC 27292-4142
- **Mailing address phone:** (336) 249-2906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/27/2023
- **Last updated:** 12/27/2023