Individual
DR. BANSARI MODI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
76 BELLEVUE AVE, MONTCLAIR, NJ 07043-2430
(973) 744-3127
Mailing address
98 WINDSOR DR, PINE BROOK, NJ 07058-9654
(973) 650-9527
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D102519200
NJ
Other
Enumeration date
01/11/2013
Last updated
08/19/2022
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