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Individual

IVANA PETROVIC SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1485 1ST AVE, NEW YORK, NY 10075-1363
(646) 736-2206
Mailing address
1485 1ST AVE, NEW YORK, NY 10075-1363

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
064015
NY

Other

Enumeration date
08/13/2024
Last updated
08/13/2024
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