Individual
ANAND SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2575 W NEW HAVEN AVE, WEST MELBOURNE, FL 32904-3701
(321) 914-0929
Mailing address
2575 W NEW HAVEN AVE, WEST MELBOURNE, FL 32904-3701
(321) 914-0929
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 19903
FL
1223G0001X
General Practice Dentistry
DN19903
FL
Other
Enumeration date
08/31/2012
Last updated
03/17/2018
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