Organization
MOHEGAN LAKE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OJAS V. SHAH DDS (OWNER/PRESIDENT)
(914) 310-1609
Entity
Organization
Contact information
Practice address
1719 E MAIN ST, MOHEGAN LAKE, NY 10547-1356
(914) 528-2191
(914) 743-1579
Mailing address
1719 E MAIN ST, MOHEGAN LAKE, NY 10547-1356
(914) 528-2191
(914) 743-1579
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0556901
NY
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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