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Organization
SOMERSET DENTAL PC
Active
Organization
SOMERSET DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MITA A SHAH DDS (DENTIST PRESIDENT)
(732) 745-9898
Entity
Organization
Contact information
Practice address
1707 RT 27 SOUTH, HEMPSTEAD PLAZA, SOMERSET, NJ 08873-3908
(732) 745-9898
(732) 745-9818
Mailing address
1707 RT 27 SOUTH, HEMPSTEAD PLAZA, SOMERSET, NJ 08873-3908
(732) 745-9898
(732) 745-9818
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
807614
UNITED CONCORDIA
—
05
—
9179730
—
NJ
Enumeration date
04/17/2007
Last updated
08/22/2020
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