Individual
MR. MOHAMMAD SHAFIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
718 KNICKERBOCKER AVE, BROOKLYN, NY 11221-5333
(718) 574-9915
(718) 574-3333
Mailing address
1591 BROADWAY, BROOKLYN, NY 11207-1002
(718) 574-4961
(718) 443-8669
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
038023
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00801501
—
NY
Enumeration date
10/31/2005
Last updated
07/08/2007
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