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Individual

SHALINI GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
12160 MONTGOMERY RD, CINCINNATI, OH 45249-1731
(513) 697-4300
(513) 697-2650
Mailing address
8805 GOVERNORS HILL DR STE 105, CINCINNATI, OH 45249-3312
(513) 697-2640
(513) 697-2650

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30023848
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30-023848
STATE DENTAL LICENSE
OH
Enumeration date
11/08/2012
Last updated
11/08/2012
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