Individual
KINNAR RAMESHCHANDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
106 LEE ST, LEESBURG, FL 34748-4913
(352) 619-4089
Mailing address
106 LEE ST, LEESBURG, FL 34748-4913
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN26505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN26505
FL BOARD OF REGISTRY
FL
Enumeration date
07/20/2012
Last updated
04/05/2021
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