Individual
NISHA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
409 MAIN ST, WAKEFIELD, MA 01880-3017
(781) 850-4037
Mailing address
36 DARTMOUTH ST APT 1011, MALDEN, MA 02148-5115
(781) 224-0021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859003
MA
Other
Enumeration date
06/05/2021
Last updated
01/17/2022
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