Organization
AZURE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADITI SHAH DDS (OWNER DENTIST)
(817) 809-4445
Entity
Organization
Contact information
Practice address
5611 COLLEYVILLE BLVD STE 140, COLLEYVILLE, TX 76034-6069
(817) 809-4445
Mailing address
5611 COLLEYVILLE BLVD STE 140, COLLEYVILLE, TX 76034-6069
(817) 809-4445
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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