Individual
DR. PRACHI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1250 TECKLA PL, KIEL, WI 53042-9623
(920) 894-2305
Mailing address
1250 TECKLA PL, KIEL, WI 53042-9623
(920) 894-2305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001236-15
WI
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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