Organization
SAN TAN VALLEY ORAL FACIAL AND IMPLANT SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHITH S SHAH D.M.D., M.D. (DOCTOR/OWNER)
(480) 814-9500
Entity
Organization
Contact information
Practice address
36327 N GANTZEL RD, SUITE 102, SAN TAN VALLEY, AZ 85140
(480) 814-9500
(520) 210-0442
Mailing address
2450 W RAY RD STE 1, CHANDLER, AZ 85224-3595
(480) 814-9500
(480) 814-9501
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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