Individual
SIMI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1240 HIGHWAY 54 W STE 315, FAYETTEVILLE, GA 30214-4572
(770) 478-6878
Mailing address
1240 HIGHWAY 54 W STE 315, FAYETTEVILLE, GA 30214-4572
(352) 201-4646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
27559
FL
1223E0200X
Endodontics
Primary
DN123928
GA
Other
Enumeration date
04/03/2023
Last updated
07/02/2026
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