Individual
DR. VICKI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5707 75TH ST, KENOSHA, WI 53142-3603
(262) 697-0321
Mailing address
220 E COMMERCE CT, ELKHORN, WI 53121-4371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002430-15
WI
Other
Enumeration date
06/03/2020
Last updated
10/18/2024
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