Individual
DR. SHAHIN SHAHGOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
350 W 42ND ST, APT 15D, NEW YORK, NY 10036-6945
(614) 778-2603
Mailing address
350 W 42ND ST, APT 15D, NEW YORK, NY 10036-6945
(614) 778-2603
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21669
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2389919
—
OH
Enumeration date
06/06/2006
Last updated
09/26/2007
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