Individual
BRIAN S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
131 2ND AVE S, ST. PETERSBURG, FL 33701-4382
(727) 823-3220
(727) 823-7284
Mailing address
131 2ND AVE S, ST. PETERSBURG, FL 33701-4382
(727) 823-3220
(727) 823-7284
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019.028191
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
ME139554
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
036.125106
IL
Other
Enumeration date
06/09/2006
Last updated
06/05/2025
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