Individual
DR. SANJIV KIRTIKANT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
39915 GRAND RIVER AVE, SUITE 500, NOVI, MI 48375-2153
(248) 427-9003
Mailing address
30939 COPPER LN, NOVI, MI 48377-4537
(248) 202-4504
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16090
MI
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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