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Individual

DR. NISHA SHAH GROSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
305 W 12TH AVE, COLUMBUS, OH 43210-1267
(614) 292-2622
Mailing address
977 PENNSYLVANIA AVE, COLUMBUS, OH 43201-3334

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
RES.3107
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082517
OH
Enumeration date
07/07/2011
Last updated
07/21/2016
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