Individual
DR. PAYAL K SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
330 N JEFFERSON ST APT 1906, CHICAGO, IL 60661-1322
(224) 805-7671
Mailing address
330 N JEFFERSON ST APT 1906, CHICAGO, IL 60661-1322
(224) 805-7671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032634
IL
1223D0001X
Public Health Dentistry
019.032634
IL
1223G0001X
General Practice Dentistry
019.032634
IL
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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