Individual
KHANTIL R SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
36 BRIDGE WAY, PASCOAG, RI 02859-3131
(401) 567-0800
(401) 568-0582
Mailing address
PO BOX 312, PASCOAG, RI 02859-0312
(401) 567-0800
(401) 567-0900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
04079
NH
Other
Enumeration date
08/08/2014
Last updated
07/17/2015
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