Individual
JALAK SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1240 E BASELINE RD STE 100, MESA, AZ 85204-6700
(480) 576-7378
Mailing address
800 N CENTRAL AVE APT 908, PHOENIX, AZ 85004-2765
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D012307
AZ
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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