Individual
KOSHA K SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
150 SOUTHFIELD AVE, 2203, STAMFORD, CT 06902-7756
(650) 288-8453
Mailing address
11 GRACE ST, FAIRFIELD, CT 06825-7415
(650) 288-8453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10127
CT
Other
Enumeration date
07/06/2009
Last updated
09/06/2011
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