Organization
SAMIR SHAH DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR SHAH DDS (OWNER)
(909) 746-0444
Entity
Organization
Contact information
Practice address
469 W BASE LINE RD, RIALTO, CA 92376-3379
(909) 746-0444
Mailing address
469 W BASE LINE RD, RIALTO, CA 92376-3379
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
53272
CA
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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