Organization
GP DENTISTRY FAIRFIELD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KOSHA SHAH DDS (OWNER DENTIST)
(650) 288-8453
Entity
Organization
Contact information
Practice address
400 POST RD, FAIRFIELD, CT 06824-6244
(203) 255-2493
(203) 255-9468
Mailing address
400 POST RD, FAIRFIELD, CT 06824-6244
(203) 255-2493
(203) 255-9468
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/17/2016
Last updated
06/20/2016
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