Individual
ANITA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
4266 DULCEY DR, SAN JOSE, CA 95136-2119
(408) 772-3149
Mailing address
4266 DULCEY DR, SAN JOSE, CA 95136-2119
(408) 772-3149
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
63688
CA
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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