Individual
MAMTA M SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1100 CENTENNIAL AVE, SUITE# 101, PISCATAWAY, NJ 08854-4152
(732) 562-1111
(732) 562-9666
Mailing address
1100 CENTENNIAL AVE, SUITE 101, PISCATAWAY, NJ 08854-4152
(732) 562-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI02123400
NJ
Other
Enumeration date
08/15/2005
Last updated
07/08/2007
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