Individual
DR. AMIR SHAHLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10500 FISCHER PARK DR, LOUISVILLE, KY 40241
(502) 451-1020
Mailing address
3101 BRECKENRIDGE LN, LOUISVILLE, KY 40220-2742
(502) 451-1020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12013020A
IN
1223P0221X
Pediatric Dentistry
Primary
10082
KY
Other
Enumeration date
08/01/2014
Last updated
08/01/2018
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