Individual
DR. DEEP I. SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1073 OAK ST, PITTSTON, PA 18640-3716
(570) 654-4141
(570) 654-2150
Mailing address
625 CORNFIELD WAY, APT. 201, DALLAS, PA 18612-7215
(215) 272-7446
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS040290
PA
1223P0221X
Pediatric Dentistry
Primary
DS040290
PA
Other
Enumeration date
03/30/2015
Last updated
01/28/2016
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